In this study, we investigated the adoption decisions of two clinical units of a Hong Kong based teaching and public hospital in choosing and the subsequent diffusion of telemedicine technology. The findings suggest that when making adoption decisions, an organization needs to consider not only the innovation attributes but also the organizational characteristics including needs, structure, members?? attitudes and decision making practices. This study also suggests an internal champion, convenient access, member involvement and rewards be essential in diffusing adopted innovations in organizations. Furthermore, comprehensive adoption decision making may be a necessary but not sufficient condition for effective organizational innovation diffusion.