'Ready for tomorrow: eHealth readiness in top clinical hospitals surveyed

Technological innovations such as eHealth are vital for improving healthcare accessibility, quality, and sustainability. While most research addresses adoption at the individual or team level, less is known about organisational factors enabling sustainable transformation. Organisational readiness is a key determinant of success. The Organizational eHealth Readiness (OeHR) model, developed in Polish primary care, assesses five dimensions: Strategy, Competence, Culture, Structure, and Technology, but its applicability in Dutch health care remains unclear. This mixed-methods study evaluated the OeHR model in Dutch hospitals. A validated 32-item questionnaire, translated into Dutch, was completed by managers and implementation specialists of 15 top-clinical hospitals (n=22). Descriptive statistics, regression analyses, and Principal Component Analysis provided insight into how the five dimensions jointly reflect organisational readiness for eHealth. Three focus groups (n=14) in two hospitals explored construct interpretation, missing dimensions, and model usability. Qualitative data were analysed using deductive coding on OeHR dimensions and emergent themes to refine the questionnaire. Quantitative analyses identified organisational culture as the only significant predictor of subjective eHealth readiness, while other dimensions showed no independent effect. Open responses and focus groups confirmed the centrality of culture and suggested refinements to all components, including clearer definitions, structural flexibility, and attention to external factors. Overall, the OeHR model was valued for strategic guidance but required contextualisation for practical use. This study showed that the OeHR model provides a valuable framework for assessing eHealth readiness in Dutch hospitals, with cultural readiness emerging as the most influential yet conceptually ambiguous dimension. Strategy, competence, structural and technological readiness mainly act as contextual enablers rather than direct predictors. The findings highlight the need to refine definitions, reduce overlap, and explore additional layers such as personal, operational, and societal readiness. Strengthening conceptual clarity and developing context-sensitive tools could enhance applicability and guide hospitals in translating readiness into digital transformation. Author summaryeHealth, such as home monitoring and online consultations with healthcare providers, is becoming increasingly important. Hospitals want to implement eHealth effectively, but this is only possible if the organisation is ready for it. The Organisational eHealth Readiness model helps to assess how "eHealth-ready" an organisation is. This model looks at five components: strategy, competencies, culture, structure and technology. In our research, we examined whether this model is also suitable for Dutch hospitals and which factors were still missing. We did this using a questionnaire among professionals and three focus groups, all involved in the implementation of eHealth. This showed that all components of the model are important, but that the culture of the organisation plays a central role. If employees are open to change and innovation, this acts as a driving force for eHealth. The other components, such as technology and strategy, appear to be primarily preconditions: necessary, but not sufficient to enable real change. Participants found the model useful, but felt that some factors were missing, such as leadership, collaboration, flexibility and the influence of legislation and regulations. They also mentioned that the organisation must have the capacity to cope with change effectively. Adapting the model to include these points could better support hospitals in healthcare transformation in the future.