The ISHIMR conference encourages researchers and practitioners working with information and communication technologies (ICTs) in the healthcare sector to present their latest research and developments. The theme for ISHIMR 2009 was 'Evaluation and implementation of e-health and health information initiatives: international perspectives' and a range of papers and posters on this theme were presented during the conference. This special issue contains six of the best papers from the conference, as reviewed by the ISHIMR 2009 Programme Committee. The selected papers are from a range of countries, i.e. the US, England, Wales and Malaysia, giving an international perspective, and utilize a range of qualitative and quantitative methodologies.Urquhart and Currell discuss the controversies surrounding home uterine monitoring, using a socio-technical interaction networks (STIN) approach.1 Building on a Cochrane systematic review of telemedicine, the authors identified 14 studies from 15 papers on home uterine monitoring and applied the STIN approach. The article describes the STIN approach and discusses its adaptation to critique the studies included in the review and to map the decisions made regarding home uterine monitoring to the socio-technical characteristics of a home uterine monitoring system. Urquhart and Currell concluded from their study that using the STIN approach helped in understanding the apparent failure of home uterine monitoring, above and beyond that which was learned from the systematic review itself.Dalrymple et al.'s article describes their qualitative study investigating why an evidence-based anticoagulation guideline was being applied irregularly within a hospital in the US.2 The authors used semi-structured interviews with internal medicine residents who were responsible for managing anticoagulant therapy from one unit within the hospital and also used field observations from similar units and ward rounds to provide a rich description and identify contextual factors. They used Roger's diffusion of innovation theory to analyse how evidence was evaluated and applied when caring for their patients. The authors' conclusions emphasize the need for greater in-depth analysis in the early stages of proposed changes, and stress the importance of identifying barriers to, and incentives for, these changes to ensure that they are implemented effectively. From a methodological perspective, the authors also conclude that multi-method, qualitative designs should be used to explore how people interact with information and the changes that arise as a result of information.Ayatollahi et al. describe factors influencing the use of IT in an emergency department (ED).