E-Government projects are currently service oriented, focusing on the implementation and diffusion of digital public services through one-stop points of access for citizens.
Thus, healthcare providers have a direct role to play in the implementation and diffusion of telemonitoring services.
In Canada, the implementation and the diffusion of telehealth and EHR in the health care system is a priority for the next years [ 10].
For innovation research, this means that when studying implementation, taking account of the number of stakeholders involved in the implementation decision and how they benefit from or pay for the implementation and use of the innovation may increase the understanding of the (lack of) speed of the diffusion process.
Guideline characteristics [ 28, 29], chosen strategies for implementation and diffusion [ 2, 30, 31], and attitudes and motivation of health professionals [ 24, 32] have for example been shown to affect the outcome of the implementation process.
This was visible at multiple time points in the initiation, implementation and diffusion of service innovations.
The Institute of Medicine's report, Crossing the Quality Chasm: A New Health System for the 21st Century, summarized the difficulty of effective implementation and diffusion of proven health-care interventions (41).
A conceptual framework for improving practice is needed to integrate the key features for successful program design, predictors of implementation and diffusion, and appropriate outcome measures.
This trial adds further evidence to the concept that telemonitoring is worth of implementation and diffusion as a component of the care of COPD.
With the focus being predominantly on the adoption stage, little is known about the factors influencing the implementation and continuation stages of the diffusion process.
