Purpose - The purpose of this study is to receive an understanding for how to enable higher rates of adoption implementation success of hospital IT (HIT) systems in ambulatory surgical care settings.   Method - The study is an explorative deductive multiple case-study, incorporating 15 ambulatory surgical centers situated in Sweden, Germany, and the United States. In total, 24 interviews were conducted with managers and users at the selected ASCs in three waves and analyzed through thematic analysis.   Findings - The study resulted in the identification of six barriers and eight enablers in the adoption- and implementation phase of HIT systems. In addition, an implementation framework was developed based on the findings from RQ1 and RQ2, with critical activities to execute to facilitate adoption- and implementation success of HIT systems in ASCs.   Theoretical contribution - This study adds to the literature by identifying new barriers and enablers in HIT adoption and implementation characterizing ambulatory surgical centers. Furthermore, the findings extend on previous literature by presenting an new all-encompassing implementation framework, showing the necessity to approach the implementation process as a whole process-improvement project for successful HIT adoption and implementation.  Managerial implications - This study emphasizes the important role managers in ambulatory surgical centers hold in facilitating successful HIT implementation and provides managers with a practical implementation framework to serve as a roadmap to guide them in achieving a successful implementation of HIT systems.   Limitations and future research - The study is limited to investigating adoption- and implementation of HIT systems (EHR, EMR, HIS) in the context of ambulatory surgical centers. Future studies can explore the identified barriers and enablers in more ambulatory surgical settings and extend upon the developed implementation framework.

Abstract Background: The fast development of technological systems has caused variouschallenges in the business management world, both from an employee and organizationalperspective. Despite the potential for exponential growth in information technology, thereis limited research in IT implementation literature. Adaptability in the workplace has beengreatly affected as humans are resistant to change. From an organizational perspective, theadoption/implementation of technological systems can be affected by the cost ofinvestment, resistance to change and the difficulties of integrating new technologies withexisting systems and processes. Purpose: The establishment of a framework that explains the process of IT adoption.Moreover, an investigation of how organizations and managers can efficiently manage theprocess of successful technology adoption and employee adaptation in an organization. Method: The qualitative study is grounded in an epistemological interpretivism paradigm.Through the usage of semi structured interviews and the Gioia coding analysis method, anexpert interview study was conducted. Conclusion: The research culminates in the creation of a loop model that explains the stepsof a successful IT adoption. The study identifies major challenges related to technologicalchange such as employee resistance and communication. It also highlights the importanceof managers and their respective characteristics required to address such challenges, which2are communication skills, expertise in the field and effective leadership. The studydevelops on the value creation opportunities of IT adoption.