OBJECTIVES: Health technology assessment (HTA) is not deeply rooted in Finnish hospitals despite of long lasting attempts to introduce it into routine decision making. Both the processes and content of the HTA approach have been challenged. The EU-funded AdHopHTA project has provided good practices and new tools for hospital based HTA. The aim of this study is to smoothen the introduction of these new tools by examining the obstacles HTA currently faces in hospitals.  METHODS: Semi-structured group interviews in five public hospitals and two health care centres. Interviewees were clinical unit managers, division managers, and financial or procurement managers. Questions were related to the process of proposing, evaluating, deciding and procuring new technologies. A mini-HTA sheet was tested during the interview and questions asked about the relevance and clarity of the questions. RESULTS: The current processes of the uptake of technologies is relatively similar in all studied hospitals. There are no standard, transparent evidence requirements, nor systems to assess and document the rationales for uptake. The clinicians report their needs in free format; the HTA-tools are not know nor used. After reducing the number of questions in the mini-HTA-sheet and making some changes to its content, order and terminology, the willingness to use increased. Information needed for budget impact analysis was considered of particular interest. Procurement officials were strong proponents of systematic and transparent assessment.  CONCLUSIONS: HTA tools need to be tailored to the hospitals. Instead of top-down requests for HTA, a low threshold tool is needed to document and justify the need of a new technology. This would pave the way for managers with financial responsibility to request more thorough assessments. This is the point where the new AdHopHTA tools could come in place.