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Most theoretical approaches to evaluate implementation of EHR systems origins from the time when EHR systems replaced paper records. When staff and management have many years’ experience in use of EHR, the approaches to implementation is different. In this protocol paper we review the main implementation theories and discuss the adequacy for planning and evaluation of implementation of third generation EHR. Finally, we present a model to understand relations between leadership, the implementation of the EHR system in the individual clinical departments, the perception of the staff and the quality of care. The model is used to outline five hypothesis that can be tested in a specific evaluation project.
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