In a complex and fragile context characterized by a will to improve the care and the healthcare costs, IS are perceived as one of the main pillars of the ongoing organizational redesign of the healthcare system. Most significantly, telemedicine appears as an essential organizational innovation to mitigate the current weaknesses of the healthcare system and ensure equitable access to quality care. Viewed as key element the health chain, telemedicine development requires a major organizational and cultural change for the care units and their patients. Departing from this context, our research provides a study on the technology, organizational and external factors of the telemedicine implementation in French care homes. To achieve this objective, we combine in an exploratory approach two different data sources. The first one which is secondary and declarative data mobilize a survey of the Observatory of the reconstruction of healthcare of the DGOS (Direction Générale de l'Offre de Soins) concerning the care homes recorded since 2008 in France. In a later stage, to deepen and sharpen this first analysis, a second data source has been collected. This is based on twenty-two interviews with actors involved in the implementation of telemedicine solutions within French care homes. Our findings reveal that the emergence of telemedicine is due to the need of an external coordination of healthcare supply on a specific territory rather than internal organic growth or technology and structural maturity. On this last point, the technological factor, we observe the opposite trend, a concomitant development stage of integrated IS and telemedicine projects. The main theoretical contribution of this research is to discuss the link between internal and external integration within digital trajectories