{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T13:27:48Z","timestamp":1758806868967,"version":"3.37.3"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,4,24]],"date-time":"2021-04-24T00:00:00Z","timestamp":1619222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"National Science Foundation Research Experience for Undergraduates","award":["#1757644"],"award-info":[{"award-number":["#1757644"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Successful technological implementations frequently involve individuals who serve as mediators between end users, management, and technology developers. The goal for this project was to evaluate the structure and activities of such mediators in a large-scale electronic health record implementation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Field notes from observations taken during implementation beginning in November 2017 were analyzed qualitatively using a thematic analysis framework to examine the relationship between specific types of mediators and the type and level of support to end users.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We found that support personnel possessing both contextual knowledge of the institution\u2019s workflow and training in the new technology were the most successful in mediation of adoption and use. Those that lacked context of either technology or institutional workflow often displayed barriers in communication, trust, and active problem solving.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings suggest that institutional investment in technology training and explicit programs to foster skills in mediation, including roles for professionals with career development opportunities, prior to implementation can be beneficial in easing the pain of system transition.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jamia\/ocab044","type":"journal-article","created":{"date-parts":[[2021,3,7]],"date-time":"2021-03-07T12:07:23Z","timestamp":1615118843000},"page":"1543-1547","source":"Crossref","is-referenced-by-count":13,"title":["Enabling adoption and use of new health information technology during implementation: Roles and strategies for internal and external support personnel"],"prefix":"10.1093","volume":"28","author":[{"given":"Claire N","family":"Umstead","sequence":"first","affiliation":[{"name":"Department of Biology, Murray State University, Murray, Kentucky, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-3677","authenticated-orcid":false,"given":"Kim M","family":"Unertl","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy M","family":"Lorenzi","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0415-4301","authenticated-orcid":false,"given":"Laurie Lovett","family":"Novak","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,24]]},"reference":[{"issue":"3","key":"2021071421220542600_ocab044-B1","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1197\/jamia.M2583","article-title":"Crossing the implementation chasm: a proposal for bold action","volume":"15","author":"Lorenzi","year":"2008","journal-title":"J Am Med Inform Assoc"},{"issue":"4","key":"2021071421220542600_ocab044-B2","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1197\/jamia.M2373","article-title":"The extent and importance of unintended consequences related to computerized provider order entry","volume":"14","author":"Ash","year":"2007","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2021071421220542600_ocab044-B3","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1197\/jamia.M2378","article-title":"Technology implementation and workarounds in the nursing home","volume":"15","author":"Vogelsmeier","year":"2008","journal-title":"J Am Med Inform Assoc"},{"issue":"e1","key":"2021071421220542600_ocab044-B4","doi-asserted-by":"crossref","first-page":"e28","DOI":"10.1136\/amiajnl-2013-001762","article-title":"Exploring the sociotechnical intersection of patient safety and electronic health record implementation","volume":"21","author":"Meeks","year":"2014","journal-title":"J Am Med Inform Assoc"},{"issue":"2","key":"2021071421220542600_ocab044-B5","first-page":"70","article-title":"The contribution of sociotechnical factors to health information technology\u2013related sentinel events","volume":"42","author":"Castro","year":"2016","journal-title":"Jt Comm J Qual Patient Saf"},{"issue":"6","key":"2021071421220542600_ocab044-B6","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1136\/amiajnl-2011-000575","article-title":"Mediation of adoption and use: a key strategy for mitigating unintended consequences of health IT implementation","volume":"19","author":"Novak","year":"2012","journal-title":"J Am Med Inform Assoc"},{"issue":"1","key":"2021071421220542600_ocab044-B7","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1057\/palgrave.ejis.3000518","article-title":"Contextual influences on technology use mediation: a comparative analysis of electronic medical record systems","volume":"14","author":"Davidson","year":"2005","journal-title":"Eur J Inf Syst"},{"issue":"2","key":"2021071421220542600_ocab044-B8","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1108\/JSM-11-2017-0368","article-title":"Understanding technology mediation and new service provider roles in health care","volume":"33","author":"Daskalopoulou","year":"2019","journal-title":"J Serv Mark"},{"issue":"4","key":"2021071421220542600_ocab044-B9","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1287\/orsc.6.4.423","article-title":"Shaping electronic communication - the metastructuring of technology in the context of use","volume":"6","author":"Orlikowski","year":"1995","journal-title":"Organ Sci"},{"issue":"5","key":"2021071421220542600_ocab044-B10","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1057\/ejis.2012.2","article-title":"Mediating the intersections of organizational routines during the introduction of a health IT system","volume":"21","author":"Novak","year":"2012","journal-title":"Eur J Inf Syst"},{"volume-title":"Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory","year":"2014","author":"Corbin","key":"2021071421220542600_ocab044-B11"},{"key":"2021071421220542600_ocab044-B12","first-page":"57","article-title":"Technology-use mediation: making sense of electronic communication in an organizational context","volume":"16","author":"Bansler","year":"2004","journal-title":"Scand J Inf Syst"}],"container-title":["Journal of the American Medical Informatics Association"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/7\/1543\/38983195\/ocab044.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jamia\/article-pdf\/28\/7\/1543\/38983195\/ocab044.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,14]],"date-time":"2021-07-14T21:23:08Z","timestamp":1626297788000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jamia\/article\/28\/7\/1543\/6248219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,24]]},"references-count":12,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4,24]]},"published-print":{"date-parts":[[2021,7,14]]}},"URL":"https:\/\/doi.org\/10.1093\/jamia\/ocab044","relation":{},"ISSN":["1527-974X"],"issn-type":[{"type":"electronic","value":"1527-974X"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,4,24]]}}}