This paper provides empirical evidence using two studies to explain the primary factors facilitating electronic health record (EHR) systems adoption through the lens of the resource advantage theory. We aim to address the following research questions: What are the main organizational antecedents of EHR implementation? What is the role of monitoring in EHR system implementation? What are the current themes and people’s attitudes toward EHR systems? This paper includes two empirical studies. Study 1 presents a research model based on data collected from four different archival datasets. Drawing upon the resource advantage theory, this paper uses archival data from 200 Texas hospitals, thus mitigating potential response bias and enhancing the validity of the findings. Study 2 includes a text analysis of 5154 textual data, sentiment analysis, and topic modeling. Study 1’s findings reveal that joint ventures and ownership are the two main enablers of adopting EHR systems in 200 Texas hospitals. Moreover, the results offer a moderating role of monitoring in strengthening the relationship between joint-venture capability and the implementation of EHR systems. Study 2’s results indicate a positive attitude toward EHR systems. The U.S. was unique in the sample due to its slower adoption of EHR systems than other developed countries. Physician burnout also emerged as a significant concern in the context of EHR adoption. Topic modeling identified three themes: training, healthcare interoperability, and organizational barriers. In a multimethod design, this paper contributes to prior work by offering two new EHR antecedents: hospital ownership and joint-venture capability. Moreover, this paper suggests that the monitoring mechanism moderates the adoption of EHR systems in Texas hospitals. Moreover, this paper contributes to prior EHR works by performing text analysis of textual data to carry out sentiment analysis and topic modeling.