title: What is the extent of research on the characteristics, behaviors, and impacts of health information technology champions? A scoping review.
abstract: BACKGROUND
  Although champions are commonly employed in health information technology (HIT) implementations, the state of empirical literature on HIT champions' is unclear. The purpose of our review was to synthesize quantitative and qualitative studies to identify the extent of research on the characteristics, behaviors, and impacts of HIT champions. Ultimately, our goal was to identify gaps in the literature and inform implementation science.
  
  
  METHODS
  Our review employed a broad search strategy using multiple databases-Embase, Pubmed, Cinahl, PsychInfo, Web of Science, and the Cochrane library. We identified 1728 candidate articles, of which 42 were retained for full-text review.
  
  
  RESULTS
  Of the 42 studies included, fourteen studies employed a multiple-case study design (33 %), 12 additional articles employed a single-case study design (29 %), five used quantitative methods (12 %), two used mixed-methods (5 %), and one used a Delphi methodology (2 %). Our review revealed multiple categories and characteristics of champions as well as influence tactics they used to promote an HIT project. Furthermore, studies have assessed three general types of HIT champion impacts: (1) impacts on the implementation process of a specific HIT; (2) impacts on usage behavior or overall success of a specific HIT; and (3) impacts on general organizational-level innovativeness. However the extent to which HIT projects fail even with a champion and why such failures occur is not clear. Also unclear is whether all organizations require a champion for successful HIT project implementation. In other words, we currently do not know enough about the conditions under which (1) a health IT champion is needed, (2) multiple champions are needed, and (3) an appointed champion-as opposed to an emergent champion-can be successful.
  
  
  CONCLUSIONS
  Although champions appear to have contributed to successful implementation of HIT projects, simply measuring the presence or absence of a champion is not sufficient for assessing impacts. Future research should aim for answers to questions about who champions should be, when they should be engaged, what they should do, how management can support their efforts, and what their impact is given the organizational context.
authors.affiliation: CB# 7411 McGavran-Greenberg Hall, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27599-7411, USA. chris_shea@unc.edu.
authors.forename: Christopher Michael
authors.initials: CM
authors.lastname: Shea
authors.affiliation: CB# 7411 McGavran-Greenberg Hall, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, 27599-7411, USA. mike.belden@unc.edu.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Belden
mesh_terms: D006302:Health Services Research / Q000706:statistics & numerical data; D006801:Humans; D008490:Medical Informatics / Q000706:statistics & numerical data