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Many firms in Korea have adopted and used advanced information technology in an effort to boost efficiency. The process of adapting to the new technology, at the same time, can vary from one firm to another. As such, this research focuses on several relevant factors, especially the roles of social interaction as a key variable that influences the technology adaptation process and the outcomes. Thus far, how a firm goes through the adaptation process to the new technology has not been yet fully explored. Previous studies on changes undergone by a firm or an organization due to information technology have been pursued from various theoretical points of views, evolved from technological and institutional views to an integrated social technology views. The technology adaptation process has been understood to be something that evolves over time and has been regarded as cycles between misalignments and align-ments, gradually approaching the stable aligned state. The adaptation process of the new technology was defined as “appropriation” process according to Poole and DeSanctis [1994]. They suggested that this process is not automatically determined by the technology design itself. Rather, people actively select how technology structures should be used; accordingly, adoption practices vary. But concepts of the appropriation process in these studies are not accurate while suggested propositions are not clear enough to apply in practice. Furthermore, these studies do not substantially suggest which factors are changed during the appropriation process and what should be done to bring about effective outcomes.Therefore, research objectives of this study lie in finding causes for the difference in ways in which advanced information technology has been used and adopted among organizations. The study also aims to explore how a firm’s interaction with social as well as technological factors affects differently in resulting organizational changes. Detail objectives of this study are as follows. First, this paper primarily focuses on the appropriation process of advanced information technology in the long run, and we look into reasons for the diverse types of the usage. Second, this study is to categorize each phases in the appropriation process and make clear what changes occur and how they are evolved during each phase. Third, this study is to suggest the guidelines to determine which strategies are needed in an individual, group and organizational level. For this, a sub-stantially grounded theory that can be applied to organizational practice has been developed from a longi-tudinal comparative case study.For these objectives, the technology appropriation process was explored based on Structuration Theory by Giddens [1984], Orlikoski and Robey [1991] and Adaptive Structuration Theory by Poole and DeSanctis [1994], which are examples of social technology views on organizational change by technology. Data have been obtained from interviews, observations of medical treatment task, and questionnaires administered to group members who use the technology. Data coding was executed in three steps following the grounded theory approach. First of all, concepts and categories were developed from interviews and observation data in open coding. Next, in axial coding, we related categories to subcategorize along the lines of their properties and dimensions through the paradigm model. Finally, the grounded theory about the appropriation process was developed through the conditional/consequential matrix in selective coding.In this study eight hypotheses about the adaptation process have been clearly articulated. Also, we found that the appropriation process involves through three phases, namely, “direct appropriation,” “cooperate with related structures,” and “interpret and make judgments.” The higher phases of appropriation move, the more users represent various types of instrumental use and attitude. Moreover, the previous structures like “knowledge and experience,” “belief that other members know and accept the use of technology,” “horizontal communication,” and “embodiment of opinion collection process” are evolved to higher degrees in their dimensions of property. Furthermore, users continuously create new spirits and structures, while removing some of the previous ones at the same time. Thus, from longitudinal view, faithful and unfaithful appropriation methods appear recursively, but gradually faithful appropriation takes over the other. In other words, the concept of spirits and structures has been changed in the adaptation process over time for the purpose of alignment between the task and other structures.These findings call for a revised or extended model of structural adaptation in IS (Information Systems) literature now that the vague adaptation process in previous studies has been clarified through the in-depth qualitative study, identifying each phrase with accuracy. In addition, based on these results some guidelines can be set up to help determine which strategies are needed in an individual, group, and organizational level for the purpose of effective technology appropriation. In practice, managers can focus on the changes of spirits and elevation of the structural dimension to achieve effective technology use.