This study analyze s the mechanisms that underlie ehealth uptake in the Netherlands. Taking a Technological Innovation Systems (TIS) approach, through interviews, observation and document analysis the seven functions of the innovation system for ehealth are analyzed and barriers to system development are identified . The study finds that financia l resource mobilization, resistance to change, market formation and to some extent ‘guidance of the search’ are hampering the development of e-health, even though the latter is increasingly taking shape through formation of active networks of health profe ssionals and managers, and ICT professionals. In addition, findings suggest that both organizational and geographical proximity matter in the collaborative development of e -health. It is essential that the mechanisms that hamper the development of ehealth are addressed, if the healthcare system in the Netherlands is to develop towards a truly citizen -centered system. Addressing problems related to financial incentives and business cases, in addition to the creation of stronger inter-organizational networks to spur vision creation and knowledge development and exchange, are means to enhance the functions of the innovation system.