The electronic health record (EHR) recently emerged as a new tool for delivering care to patients in hospitals. Cost savings due to EHR adoption were projected from reduced length of stays from streamlining processes, fewer preventable errors due to clinical decision support, and a general increase in the efficiency of care delivery. I conducted a systematic review and meta-analysis of quantitative research that evaluated the relationship between EHRs and hospital costs. I find hospitals with EHRs with basic capabilities were found to have 12% lower average costs than comparable hospitals, whereas hospitals with more advanced EHRs did not have significantly lower costs. These results may allude to marginal declines in the cost-effectiveness of advanced EHR capabilities.