eHealth adoption factors in medical hospitals: A focus on the Netherlands

Int J Med Inform. 2017 Apr;100:77-89. doi: 10.1016/j.ijmedinf.2017.01.009. Epub 2017 Jan 21.


Background: Despite strong policy interest in eHealth, actual adoption in many European hospitals is low.

Purpose: This study develops and tests in a preliminary way an organisational eHealth adoption model rooted in several adoption frameworks to improve understanding of this phenomenon.

Methods: The model is explored through a survey among hospitals in the Netherlands using a Structural Equation Modelling (SEM) approach. Specific attention is paid to measurement of organisational readiness and to adoption as a process including different stages.

Results: Our results suggest a sharp decrease in the adoption process by hospitals after the stage of interest/commitment. Adoption tends to be significantly affected by size of the hospital, organisational readiness including technical aspects, and top management support.

Conclusions: eHealth adoption tends to be not a linear process nor a linear function of contextual antecedents. Organisational readiness is an important antecedent for eHealth adoption. The paper concludes with organisational strategies and policies to foster eHealth adoption in hospitals and suggestions for future study.

Keywords: Diffusion of innovations (DOI); Hospitals; Organisational adoption; Structural equation modelling; Technological-organisational-environmental (TOE) framework; eHealth.

MeSH terms

  • Electronic Health Records / statistics & numerical data*
  • Health Policy
  • Hospitals / standards*
  • Humans
  • Models, Organizational*
  • Netherlands
  • Software*
  • Telemedicine / statistics & numerical data*