Adoption of eHealth in hospitals and in cities: A myriad of influences

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.