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Open Access Highly Accessed Research article

IT adoption of clinical information systems in Austrian and German hospitals: results of a comparative survey with a focus on nursing

Ursula Hübner1*, Elske Ammenwerth2, Daniel Flemming1, Christine Schaubmayr3 and Björn Sellemann1

Author Affiliations

1 Health Informatics Research Group, Faculty of Business Management and Social Sciences, University of Applied Sciences, Caprivistr. 30A, D-49076 Osnabrück, Germany

2 Institute for Health Information Systems, UMIT - University for Health Sciences, Medical Informatics and Technology, Eduard Wallnöfer-Zentrum 1, A-6060 Hall/Tyrol, Austria

3 Nursing Management, TILAK - Tiroler Landeskrankenanstalten, Anichstraße 35, A-6020 Innsbruck, Austria

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BMC Medical Informatics and Decision Making 2010, 10:8  doi:10.1186/1472-6947-10-8

Published: 2 February 2010



IT adoption is a process that is influenced by different external and internal factors. This study aimed

1. to identify similarities and differences in the prevalence of medical and nursing IT systems in Austrian and German hospitals, and

2. to match these findings with characteristics of the two countries, in particular their healthcare system, and with features of the hospitals.


In 2007, all acute care hospitals in both countries received questionnaires with identical questions. 12.4% in Germany and 34.6% in Austria responded.


The surveys revealed a consistent higher usage of nearly all clinical IT systems, especially nursing systems, but also PACS and electronic archiving systems, in Austrian than in German hospitals. These findings correspond with a significantly wider use of standardised nursing terminologies and a higher number of PC workstations on the wards (average 2.1 PCs in Germany, 3.2 PCs in Austria). Despite these differences, Austrian and German hospitals both reported a similar IT budget of 2.6% in Austria and 2.0% in Germany (median).


Despite the many similarities of the Austrian and German healthcare system there are distinct differences which may have led to a wider use of IT systems in Austrian hospitals. In nursing, the specific legal requirement to document nursing diagnoses in Austria may have stimulated the use of standardised terminologies for nursing diagnoses and the implementation of electronic nursing documentation systems. Other factors which correspond with the wider use of clinical IT systems in Austria are: good infrastructure of medical-technical devices, rigorous organisational changes which had led to leaner processes and to a lower length of stay, and finally a more IT friendly climate. As country size is the most pronounced difference between Germany and Austria it could be that smaller countries, such as Austria, are more ready to translate innovation into practice.