This chapter investigates adoption of medical technology in the form of eHealth solutions in hospitals. A model of organizational eHealth adoption is developed and empirically explored using a survey among hospitals in cities in the Netherlands and structural equation modelling (SEM). Technology adoption is seen as a process in different stages, revealing a high level of interest (about 60 per cent of hospitals) but very limited actual adoption (ranging from 6 per cent to 23 per cent). Furthermore, adoption levels tend to be higher in larger cities, and this is confirmed by significant direct influence of urban size on eHealth adoption. Other important factors tend to be organizational readiness and top management of hospitals, but these are not affected by urban size. The results leave the question open as to what makes hospitals in large cities more often adopt new technology if this is not mediated by hospital size and other organizational characteristics.@en

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.

@en