Ranked Levels of Influence model: Selecting influence techniques to minimize IT resistance

Implementation of electronic health records (EHR), particularly computerized physician/provider order entry systems (CPOE), is often met with resistance. Influence presented at the right time, in the right manner, may minimize resistance or at least limit the risk of complete system failure. Combini...

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Bibliographic Details
Published in:Journal of biomedical informatics 2011-06, Vol.44 (3), p.497-504
Main Authors: Bartos, Christa E., Butler, Brian S., Crowley, Rebecca S.
Format: Article
Language:English
Subjects:
Clinical informatics
Electronic Health Records
Hawaii
Hospital information systems
Human factors
Humans
Influence
Medical Informatics
Medical Order Entry Systems
Models, Theoretical
Physicians
Power
Resistance
Socio-technical
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Summary:Implementation of electronic health records (EHR), particularly computerized physician/provider order entry systems (CPOE), is often met with resistance. Influence presented at the right time, in the right manner, may minimize resistance or at least limit the risk of complete system failure. Combining established theories on power, influence tactics, and resistance, we developed the Ranked Levels of Influence model. Applying it to documented examples of EHR/CPOE failures at Cedars-Sinai and Kaiser Permanente in Hawaii, we evaluated the influence applied, the resistance encountered, and the resulting risk to the system implementation. Using the Ranked Levels of Influence model as a guideline, we demonstrate that these system failures were associated with the use of hard influence tactics that resulted in higher levels of resistance. We suggest that when influence tactics remain at the soft tactics level, the level of resistance stabilizes or de-escalates and the system can be saved.
ISSN:1532-0464
1532-0480
DOI:10.1016/j.jbi.2010.02.007