ABSTRACT
This chapter begins with a summary of the findings in terms of multiple successes and failures. The different ways that respondents accounted for successes and failures are summarised, along with the barriers and facilitators to implementation explicit or implicit in those accounts. An awareness of dissemination research helped in the choice of implementation sites. Hawaii Kaiser Permanente came to recognise the folly of organisational intervention without close analysis: prior to, during and after implementation. Hawaii Kaiser Permanente was fortunate to have promoted team working prior to and as part of Clinical Information System (CIS) implementation. The chapter begins by deconstructing CIS implementation from a mythical unitary entity into an actual plurality of events and processes as evidenced by the interviews. The quality of the decision to adopt CIS was seen as one reason behind its failure. CIS involved a microscopic examination of care processes.
