The Pivotal Role of Change Appropriation in the Implementation of Health Care Technology

The implementation of electronic health records (EHRs) is a major transformation in health care organizations. This study uses adaptive structuration theory to build and test an organizational change appropriation model. We tested this model in a health care organization that had recently implemented an EHR system. We find that social interaction with coworkers has a negative direct effect on employees' change attitudes, perceived change success, and perceived change communication quality. While these findings suggest that interacting with coworkers can actually increase negative perceptions of EHR implementation, the direction of these relationships is inverted when change appropriation is included in the model as a mediating variable. As health care workers adapt this particular technology system to meet their needs, they perceive the EHR implementation more positively and have more positive attitudes toward the change. Implications and future directions are also discussed.