Abstract
BackgroundAlthough champions are commonly employed in health information technology (HIT) implementations, the state of empirical literature on HIT champions’ is unclear. The purpose of our review was to synthesize quantitative and qualitative studies to identify the extent of research on the characteristics, behaviors, and impacts of HIT champions. Ultimately, our goal was to identify gaps in the literature and inform implementation science.MethodsOur review employed a broad search strategy using multiple databases—Embase, Pubmed, Cinahl, PsychInfo, Web of Science, and the Cochrane library. We identified 1728 candidate articles, of which 42 were retained for full-text review.ResultsOf the 42 studies included, fourteen studies employed a multiple-case study design (33 %), 12 additional articles employed a single-case study design (29 %), five used quantitative methods (12 %), two used mixed-methods (5 %), and one used a Delphi methodology (2 %). Our review revealed multiple categories and characteristics of champions as well as influence tactics they used to promote an HIT project. Furthermore, studies have assessed three general types of HIT champion impacts: (1) impacts on the implementation process of a specific HIT; (2) impacts on usage behavior or overall success of a specific HIT; and (3) impacts on general organizational-level innovativeness. However the extent to which HIT projects fail even with a champion and why such failures occur is not clear. Also unclear is whether all organizations require a champion for successful HIT project implementation. In other words, we currently do not know enough about the conditions under which (1) a health IT champion is needed, (2) multiple champions are needed, and (3) an appointed champion—as opposed to an emergent champion—can be successful.ConclusionsAlthough champions appear to have contributed to successful implementation of HIT projects, simply measuring the presence or absence of a champion is not sufficient for assessing impacts. Future research should aim for answers to questions about who champions should be, when they should be engaged, what they should do, how management can support their efforts, and what their impact is given the organizational context.
Highlights
Champions are commonly employed in health information technology (HIT) implementations, the state of empirical literature on HIT champions’ is unclear
Between 2009 and 2012, physician adoption of electronic health records (EHR) technology used to demonstrate five Meaningful Use core objectives increased by approximately 66 % [1], and by the end of 2012, more than 75 % of all eligible U.S hospitals had qualified for financial incentives [2]
Unclear is whether all organizations require a champion for successful HIT project implementation
Summary
Champions are commonly employed in health information technology (HIT) implementations, the state of empirical literature on HIT champions’ is unclear. Between 2009 and 2012, physician adoption of EHR technology used to demonstrate five Meaningful Use core objectives increased by approximately 66 % [1], and by the end of 2012, more than 75 % of all eligible U.S hospitals had qualified for financial incentives [2]. In addition to Meaningful Use, value-based payment and care delivery models in the U.S, such as Accountable Care Organizations, are increasing the need for health care providers and organizations to exchange patient information electronically [4], incentivizing the adoption of interoperable EHR systems. Adoption of EHRs and other HIT is increasing, implementation of these innovations carries substantial risk due to the financial investment required, the potential to negatively affect the provider and patient experience, and the opportunity cost of failure. Because of the risk and complexity involved, organizations are typically advised to undergo a careful planning process and dedicate adequate financial and human resources in order to deploy successful implementation strategies [6, 7]
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