| Although electronic health records are recognized as a key factor in transforming United States health care, adoption of electronic health records remains low as health care organizations fail to sustain this technology. Sustainability of health information technology projects depends on successfully assimilating new technologies into daily routines, using strategies to combine technology, processes, and people. In this qualitative, single-case study of an Arkansas community health center, participant perspectives of why and how the community health center was successful in addressing the human factors of sustaining health information technology were explored using a transformational paradigm that focused on the system with attention to the organization, its people, processes, and viewed technology and innovation as enablers. Purposive sampling was used to identify 11 expert participants to participate in semistructured interviews and a focus group activity. Audio-recorded data were transcribed and textual data from interviews, participant observations, and archival documents were organized according to an initial set of codes and uploaded into NVivo8 software for analysis. Three themes emerged through exploration of the data that included (a) knowledge, (b) change, and (c) functionality. The empirical evidence indicated that strategies used by the health information technology team for addressing the human factors of adopting health information technology in the center were aligned with the transformational paradigm for technology adoption supported in recent research. In addition, the strategies used to address human factors for operationalizing health information technology were consistent with the strategies used to address these factors during the adoption of technology. Recommendations resulting from this study include further research of successful operationalization of electronic health records among community health centers, development of best practice guidelines for adopting and sustaining health information technology, and expansion of federal resources to promote adoption and operationalization of this technology in community health centers. Considering the increasing burden of uncompensated care on community health centers, the successful use of health information technology could assist these organizations in leveraging resources so they can remain a viable member of the health care safety net. |
