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Currently submitted to: JMIR Medical Informatics

Date Submitted: Dec 7, 2019
Open Peer Review Period: Dec 7, 2019 - Feb 1, 2020
(currently open for review)

Factors influencing the adoption of health information standards: a “Best-fit” framework synthesis

  • Lu Han; 
  • Jing Liu; 
  • Richard Evans; 
  • Yang Song; 
  • Jingdong Ma; 



The deployment of Health Information Technologies (HIT) has often been conducted in silos, at different organizational levels, in different regions and in various healthcare settings; this has resulted in HIT infrastructures often being difficult to integrate or manage. Health information standards are expected to address these issues, yet their adoption remains frustratingly low.


To synthesize a comprehensive framework of factors that affect the adoption and deployment of health information standards by healthcare organizations.


We conducted a systematic review combined with a “Best-fit” framework synthesis approach to develop a comprehensive framework.


In total, 35 records were incorporated in our analysis, with the final synthesized framework including four dimensions, namely: Technology, Organization, Environment and Inter-organizational relationships. The technology dimension included: Relative advantage, Complexity, Compatibility, Trialability, Observability, Switching cost, Standards uncertainty and Shared business process attributes. The organization dimension included: Organizational scale, Organizational culture, Staff resistance to change, Staff training, Top management support and Organizational readiness. The environment dimension comprised: External pressure, External support, Network externality, Installed base/drag, and Information communication. The inter-organizational relationships dimension included: Partner trust, Partner dependence, Relationship commitment, and Partner power.


The synthesized framework has addressed the gap in knowledge of the adoption of health information standards in healthcare organizations. It provides decision makers with more understanding of the factors that hinder or facilitate the adoption of health information standards to better judge and develop suitable strategies for adoption interventions, and supplies research direction and a basis for future follow-up research.


Please cite as:

Han L, Liu J, Evans R, Song Y, Ma J

Factors influencing the adoption of health information standards: a “Best-fit” framework synthesis

JMIR Preprints. 07/12/2019:17334

DOI: 10.2196/preprints.17334


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