Health information technology (HIT) projects are highly complex social and technical endeavors. Knowledge about people, organizations, and implementation, as well as technological and maintenance issues, has grown over the years, both within medical informatics itself and through contributions from other disciplines (Ash et al., 2008; Kaplan and Shaw, 2004). There is an emerging consensus that problems are caused by social, cultural, and financial issues, and hence, are more managerial than technical (Kaplan and Harris-Salamone, 2009). For that reason, they should be analyzed by attention to both social and technical factors, as well as how they interact in the particular setting in which the project occurs.