[This article was originally published in Electronic Healthcare 9(1).]

We sought to understand the drivers and influencers that affect the time needed to adopt a health information management system in primary care offices. The results from three independent but interrelated studies were crystallized to understand how socio-technical factors affect the adoption of physician office systems. The duration of the adoption period is affected by differences between the culture and workflow of a clinic and the workflow design of its health information management software. While customized software could make adoption seamless, the cost of such systems drives physician offices to select a commercial off-the-shelf system from a list of systems pre-qualified by the jurisdictional certification organization. Jurisdictional physician office certification programs maximize the fit between physician office and health information systems by selecting a wide range of solutions to fit different practice types.