# Integrative Factors of E-Health Laboratory Adoption: A Case of Indonesia
## 1 Introduction  
The development and the use of the internet are increasing in many countries along with the development of Information and Communication Technology (ICT) nowadays. In Indonesia, the use of the internet is also growing rapidly. In 2019, Indonesia became one of the countries with the most internet users in the world as it ranked third after China and India and defeated Nigeria, Japan, Russia, and many other countries [1]. In Indonesia, internet users have increased from 2 million in 2000 to 143.26 million in 2019 or 53.20% of the total population in Indonesia [2, 3]. Digital health software applications increasingly become the choice of people in Indonesia, one of which is an e-health laboratory system service that applies a new approach to the health service system. The e-health laboratory system is a new approach to the health service system facilitated by electronic processes, internet communication, and other related technologies [4]. Doctors, laboratory assistants, nurses, patients, and guardians of patients are examples of e-health users. The use of e-health includes the provision of health services related to data, management, and interactions between health professionalsand patients [5]. E-health laboratory system can be defined as an application that offers customers with online access to get clinical information that includes laboratory test results. By collaborating or partnering with other trust clinical lab, e-health laboratory can provide various clinical laboratory examination and make the services available at many locations [6]. The e-health laboratory system in Indonesia covers all of them. The e-health laboratory system is part of eHealth in Indonesia. Generally, e-health also includes various digital applications, processes, and platforms such as remote medical consultation (TeleHealth), electronic medical record systems, smartphone applications, remote monitoring devices, biosensors, computer algorithms, and analytic tools to inform decision making [7]. In addition, other researchers state that eHealth elements include users, devices, and servers [8]. EHealth also allows legal access to health services through devices such as cellphones or certain e-health devices [5], including the patient's health status and history, or what is commonly known as an electronic health record system, which has been implemented in America since the 1990s [9]. At present, many countries have adopted the concept of e-health. This is in line with the World Health Organization (WHO) through the Global Observatory for e-health (GOe) in encouraging countries that are members to include eHealth in the health care system [10]. In Indonesia, the development of e-health is very promising. It is known that e-health can provide better health services not only at hospital level but also for primary health services and public health services [11]. The e-health system is even developed in the form of electronic health record system that is used in outpatient clinics or inpatient clinics in hospitals in developing countries to document patient data related to insurance claims, document retrieval by scanning images, laboratory results, and clinical use [6]. The application of various health services through e-health is so important in this era. Several studies on the adoption of various e-health services such as [10; 12] state that by 2020 online health services will make it easier for patients to visit their doctors, and this is provided by tertiary hospitals. The use of technology in e-health has increased significantly with several new functions that enable patient-doctor interaction in virtual consultations and telemedicine. Technology is used in the process of documenting clinical work by many organizations in e-health applications, serving doctors in primary care, expertise (specialization and subspecialty) in hospitals, private laboratories, insurance companies, and patients themselves [5].