The management of change within a clinical health information technology (HIT) project traditionally focuses on cost, schedule and scope; considered "hard" change management (CM). Despite massive funding, clinical HIT projects continue to fail suggesting that the management of risk associated with hard change elements alone, is not effective. The cause of clinical HIT failure is usually attributed to user resistance resulting in lack of adoption. With a focus on the human or "soft" side of CM, this paper investigates the key role CM has in influencing the adoption of clinical HIT. The sources of resistance are examined and several CM models are evaluated according to their ability to accommodate soft change. Recommendations are made about how future CM models might be constructed to be evaluative and sensitive to human issues. When integrated into clinical HIT project practice these models may impact adoption, improving the critical services clinical HIT is meant to support.
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