Background New technologies offer great opportunities for health care systems but can also represent significant costs. Increasing the usage and development of medical technologies balancing cost and utility is a priority for many health care managers. Ensuring maximised diffusion and uptake of new technologies can be positively impacted by the degree of involvement of end-users in the purchasing and/or development of new products. While the idea that culture can promote or inhibit innovation is not new, innovation in the health care setting has only relatively recently been explored. Little information specific to university hospitals and procurement of innovation exists. The global COVID-19 pandemic has furthermore greatly influenced healthcare in the last months including medical procurement and innovation. This protocol details a planned qualitative research study to explore cultural factors influencing innovation at European university hospitals as well as the recent impact of the COVID-19 pandemic in depth. Methods Key informant interviews will be conducted at ten European university hospitals. The semi-structured interview guide includes questions on: the perspectives and experiences of staff in relation to the procurement of innovation; examples of past or ongoing projects in this area or in the area of digital health innovation; and changes related to COVID-19. Participant characteristics will be summarised with descriptive statistics. Multi-step thematic analysis using meaning condensation will be used to analyse transcribed data. Identified concepts will be linked with existing theories and/or factors identified by literature search. Results will be presented in narrative and table formats. Historical public procurement data will be downloaded from the European Union’s public procurement records portal TED. Trends from during COVID-19 will be statistically analysed in comparison to prior years. Discussion This manuscript describes the steps of our proposed qualitative study to explore cultural factors that contribute to successful and/or unsuccessful innovation in relation to digital health procurement, and the impact of COVID-19 on this field. Results will be used to provide points for consideration when conducting procurement of innovation, an important tool that organisations can use to drive digital research and development and a policy goal for the EU. Funding This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 826157.