Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Monday, March 11, 2019 at 4:00 PM to 4:30 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Currently submitted to: Journal of Medical Internet Research

Date Submitted: Nov 26, 2019
Open Peer Review Period: Nov 26, 2019 - Jan 21, 2020
(currently open for review)

Patients' Perceptions of Barriers and Facilitators to the Adoption of e-Hospitals: Cross-sectional Analysis in China

  • Peiyi Li; 
  • Yunmei Luo; 
  • Xuexin Yu; 
  • Jin Wen; 
  • Elizabeth Mason; 
  • Weimin Li; 
  • Mohammad S. Jalali; 



As an innovative approach to distributing online healthcare services from physical hospitals to patients at a distance, e-hospitals, i.e., internet hospitals, have been extensively developed in China. This closed healthcare delivery chain was developed through combining e-hospitals with physical hospitals; treatments begin with an online consultation and registration, then patients are diagnosed and treated in a physical hospital, followed by post-treatment care and monitoring via e-hospital. This approach is promising in its ability to improve accessibility, efficiency, and quality of healthcare. Though, to achieve its potential, it is essential that patients adopt the new technology. However, there is limited research on end-users’ acceptance of e-hospitals, nor the effectivity of strategies aimed to prompt the adoption of e-hospitals in China.


To provide insight regarding the adoption of e-hospitals, this study investigated patients’ willingness to use e-hospitals, and analyzed barriers and facilitators to the adoption of the e-hospital technology.


We administered a pretested self-administered questionnaire and performed a cross-sectional analysis including 1032 patients across three hierarchical hospitals in West China from June to August 2019. Patients’ sociodemographic characteristics, medical history and current disease information, proficiency of electronic devices, previous experience of online health services, willingness to use e-hospitals, and perceived facilitators as well as barriers were surveyed. Multiple significance tests were employed to examine disparities across four age groups as well as those between patients who were willing to use e-hospitals and those who were not. Multivariate logistic regression was also performed to identify potential predictors of willingness to use e-hospitals.


Overall, it was found that 65.6% of patients were willing to use e-hospitals. Employment status (P <.05), living with children (P <.001), IT skills (P <.001), and previous experience in online healthcare (P <.001) were statistically significant predictors of willingness to use e-hospitals; while age, education level, income, medical insurance, and familiarity with e-hospitals were not. Also, the prominent facilitators of e-hospitals were convenience (94.68%) and accessibility to skilled medical experts (72.23%). The most frequently perceived barrier varied between age groups: seniors most often reported their inability to operate technological devices as a barrier (86.75%), while young respondents most often reported that their avoidance of e-hospital services was due to their accustomization to face-to-face consultation (75.00%).


We identified variables, facilitators, and barriers that play an essential role in the adoption of e-hospitals. Efforts to increase the adoption of e-hospitals should utilize these findings and be tailored towards the needs and characteristics of different subpopulations in China. Clinical Trial: N/A


Please cite as:

Li P, Luo Y, Yu X, Wen J, Mason E, Li W, Jalali MS

Patients' Perceptions of Barriers and Facilitators to the Adoption of e-Hospitals: Cross-sectional Analysis in China

JMIR Preprints. 26/11/2019:17221

DOI: 10.2196/preprints.17221


Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.