FEATURE ARTICLEA Workflow-Oriented Framework–Driven Implementation and Local Adaptation of Clinical Information Systems: A Case Study of Nursing Documentation System Implementation at a Tertiary Rehabilitation HospitalCHOI, JEEYAE DNSc, RN; KIM, HYEONEUI PhD, RNAuthor Information Author Affiliations: Professional Development, Spaulding Rehabilitation Hospital, Boston, MA (Dr Choi); Division of Biomedical Informatics, Department of Medicine, UCSD, La Jolla, CA (Dr Kim). The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article. Corresponding author: Jeeyae Choi, DNSc, RN, College of Nursing, University of Wisconsin-Milwaukee, 1921 E Hartford Ave, Cunningham Hall, Room 685, Milwaukee, WI 53211 (firstname.lastname@example.org). CIN: Computers, Informatics, Nursing: August 2012 - Volume 30 - Issue 8 - p 409-414 doi: 10.1097/NXN.0b013e3182512ffd Buy Take the CE Test Metrics Abstract Health information systems are often designed and developed without integrating users’ specific needs and preferences. This decreases the users’ productivity, satisfaction, and acceptance of the system and increases the necessity for a local adaptation process to reduce the unwanted outcomes after implementation. A workflow-oriented framework developed in a previous study indicates that users’ needs and preferences could be incorporated into the system when implementation follows the steps of the framework, eventually increasing satisfaction with and usefulness of the system. The overall goal of this study was to demonstrate application of the workflow-oriented framework to the implementation of a nursing documentation system at Spaulding Rehabilitation Hospital. In this case study, we present specific steps of implementing and adapting a health information system at a local site and raise critical questions that need to be answered in each step based on the workflow-oriented framework. © 2012 Lippincott Williams & Wilkins, Inc.