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

Bartos, CE and Butler, BS and Crowley, RS (2011) Ranked Levels of Influence model: Selecting influence techniques to minimize IT resistance. Journal of Biomedical Informatics, 44 (3). 497 - 504. ISSN 1532-0464

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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. © 2010 Elsevier Inc.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Bartos, CEceb2@pitt.eduCEB2
Butler, BS
Crowley, RS
Date: 1 June 2011
Date Type: Publication
Journal or Publication Title: Journal of Biomedical Informatics
Volume: 44
Number: 3
Page Range: 497 - 504
DOI or Unique Handle: 10.1016/j.jbi.2010.02.007
Schools and Programs: School of Medicine > Biomedical Informatics
Refereed: Yes
ISSN: 1532-0464
Article Type: Review
MeSH Headings: Electronic Health Records; Hawaii; Humans; Medical Informatics; Medical Order Entry Systems; Models, Theoretical; Physicians
Other ID: NLM NIHMS182541, NLM PMC2892561
PubMed Central ID: PMC2892561
PubMed ID: 20176135
Date Deposited: 29 Aug 2012 20:55
Last Modified: 02 Feb 2019 16:56


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