Health care services in German hospitals are causing immense expenses. Successful IT Governance

might help to support specific challenges for every organization with an adequate use of IT. The

market structure of hospitals in Germany is very heterogeneous, e.g. in size and sponsorship. This

paper analyses the state of the art of IT Governance based on a survey among 220 IT executives in

German hospitals. The quantitative analyses of collected survey data reveal that hospitals govern their

IT differently according to size and sponsorship. In addition, our analyses show that decision-making

authority for the IT budget rises with hospital size and is positively correlated with the fraction of IT

projects in the overall IT budget. We also show that the investments in innovative IT projects increase

with hospital size. Our study revealed that a high number of private and larger hospitals lack a

systematic IT Governance approach within the decision domain on IT projects. This study is the first

to shed light into the empirical situation of IT Governance in German hospitals.