A growing body of literature suggests that greater benefits of e-business will be obtained when e-business is integrated throughout a supply chain. However, organizations are still cautious in adopting e-business technologies. This paper examines whether a strategic case for e-commerce can be recognised and the factors that influence e-adoption, using e-business development models, a contingency approach and a stakeholder approach. The paper explores the link of e-commerce with strategy and the potential strategic benefits, risks and problems. This paper analysed e-adoption in four diverse healthcare supply chains in the context of the English National Health Service (NHS). The fieldwork showed there is of limited use of e- in supply chains; there are key problems associated with perceived benefits and costs by different actors both within organisations and within the chain. The paper proposes a framework to link the case for e-commerce with the achievement of strategic objectives across three inter-related domains—health, supply and business.