Theoretical framework
Although it is important to identify influential technology-related factors to analyze the complex implementation mechanisms of a digital innovation, these factors were not sufficient as explanatory variables for our theoretical framework. In our study design, we define complexity in terms of both the different levels of the social system in which an innovation is implemented and the influences of the context itself. In particular, the interaction of these factors in implementation mechanisms can be considered complex and the results unpredictable.Therefore, disaggregating the different levels of the social system of primary care organizations was an important prerequisite to make the study of the complexity of implementation mechanisms more manageable for data analysis. In a subsequent step, the disaggregation enabled us to analyze how the inhibiting or facilitating contextual factors at the different levels influence adoption [