Theorizing Organizational Change in EHR Implementation

Electronic Health Record (EHR) implementation is recognized as a transformative process in healthcare organizations, reshaping workflows, decision-making, and professional roles. While prior research has examined adoption and success factors, less attention has been given to theorizing the organizational change mechanisms that unfold implementation. Existing studies often rely on deterministic aspects failing to capture the interdependencies between sociotechnical elements. In this paper, we conducted a scoping review of theoretical frameworks used to explain EHR change. Using the scoping review, we categorized these frameworks into organizational change models, configurational perspectives, institutional perspectives, decision-making theories, adoption models, and cognitive theories. Our findings reveal a key gap: existing theorization overlooks the relational dynamics among technology, actors, and organizational structures. We argue that a broader sociotechnical orientation is the appropriate approach to fully understand how EHRs bring about change over time, contributing to the digital transformation literature in healthcare.