Organization and IS scholars interested in the impact of IT on organizational change have acknowledged the indeterminate relationship between technological and organizational change. This reality stems from the complex interaction of the institutional context with human cognition and action that determine the path that technological change take in order to bring about organizational outcomes. Yet in this milieu there is little account for why specific context or conditions are salient. The goal of this research is to understand how technological change is related to organizational change by opening up the blackbox of the work context and analyze how the material aspects of the IT artifact relate to the actors and their actions. Specifically, I studied 1) How do the design and implementation of an EMR system impact the configuration of the system? 2) How do users and their practices interact with the configured system? 3) How do these interactions influence organizational outcomes so that one site is more "successful" than another? I explore these research questions using the perspective of work an organization is engaged in, specifically how IT artifacts are relationally linked to actors, actions and the organizational context. As my research questions deal with a process issue, I conducted a longitudinal field study of an EMR system implementation beginning from the implementation phase to deployment and use phases. I analyzed archival, interviews and observations data to develop a grounded theory of technology-based organizational change. Based on my findings I developed the Work Network Model of technology-based change. The model proposes that the main mechanism of change is the network within the context of an organization's work. It also proposed that analyzing the process of multi-level political negotiations during the configuration of a new technology allows us to understand how technology-change evolve once it is introduced in an organization. Finally it shows how institutional, infrastructural and work practices play a role both during the configuration and use phase of the new technology. Apart from its theoretical contributions, this research attempts to provide a new method to consider and design work practices with new technologies via the Work Network lens.