Critical factors influencing hospitals' adoption of HL7 version 2 standards: an empirical investigation

Industry predictions focus on future e-hospitals that will integrate all stakeholders into a seamless network, allowing data to be shared. The Health Level Seven (HL7) is a standard for the interchange of data within the healthcare industry. It simplifies communication interfaces and allows the interoperability among heterogeneous applications. Although the benefits of adopting HL7 are well known, only a few hospitals in Taiwan have actually adopted it. What are the reasons behind the hospitals' lack of intention to adopt HL7? Most prior studies on HL7 have focused on technical issues and general overlooked the managerial side. This has caused a lack of understanding of factors influencing hospitals' decision on HL7 adoption. In fact, main reasons behind a hospital's decision on whether to adopt an innovative technology are more often related to organizational than purely technical issues. Hence, we pay our attention to these organizational considerations over HL7 adoption. Based on the Innovation Diffusion Theory, we proposed a research model to explore the critical factors influencing Taiwan hospitals' adoption intention of HL7. 472 questionnaires were distributed to all accredited hospitals in Taiwan and 122 were returned. The valid response rate was 25.21% (119). Factor analysis, logistic regression and Pearson Chi-square test were conducted to verify the research model. The results showed that environmental pressure, top management attitude towards HL7, staff's technology capability, system integrity, and hospital's scale were critical factors influencing hospitals' intention on whether to adopt HL7. The research findings provided the government, the healthcare industry, the hospital administrators and the academia with practical and theoretical references. These factors should be considered in planning promotion plan to encourage hospital adoption of HL7. This study also opens up a new research direction as well as a new viewpoint, and consequentially improves the completeness of related researches in the medical informatics discipline.