This study aimed to compare the use of clinical information systems, particularly for nursing, in Austria and Germany. 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 clinical IT in Austrian than in German hospitals. It also included a significant difference in the percentage of electronic nursing records in use. These findings correspond with a significantly higher number of PC workstations on the wards. Despite these differences, Austrian and German hospitals reported a nearly identical IT budget. Factors which might have influenced the wider use of clinical IT are a re-focus on clinical matters after rigorous organisational changes, legal constraints and a general IT-friendly climate in Austria.