国家在“十二五”规划中提出并具体布置了卫生信息化建设的重点“35212 工程”。

即在“十二五”期间，我国将重点建设国家级、省级和地市级三级卫生信息平台；加强
信息化在公共卫生、医疗服务、新农合、基本药物制度、综合管理五项业务中的深入应
用；建设电子健康档案和电子病历二个基础数据库；建设一个医疗卫生信息专用网络；
逐步建设信息安全体系和信息标准体系。

随着医改进行的深入，医院之间的收购，整合的趋势日益明显。传统大型综合性医
院的业务扩张的需要与日益增长的医疗服务的需求，促使各大型医院纷纷建设新院区,
或兼并和整合一些地市区级别的专科医院、地方医院等，把业务的重点和资源逐步向新
院区进行扩张。因此，集团化医院以及同一套行政体系内的多院区逐步地成为医院发展
的新的方向。国内医疗版图上正在跑马圈地中逐步形成以一家家以大型医院为龙头的集
团医疗机构。

医疗信息化是现代化医院的基础, 是临床服务必不可少环节,而大型医疗机构信息
化如何建设,如何解决新环境下所出现的问题是亟需探索的课题。

本文以Z医院这三甲综合性医院为案例, 旨在通过分析其在医院信息化建设中的发
展现状, 采用 IT 治理架构模型,从业务需求、应用系统、信息安全、风险控制、组织管
控领域探讨分析其存在的问题。采用访谈法、因果分析法，从决策、激励、控制、外部
环境四个层面分析其原因，使用了问卷调查法对问题原因深入分析与检验。进而,以 IT
治理的方法论对 Z 医院信息化的建设进行治理探讨，形成 IT 治理策略,以求解决医院信
息化中所遇到的管理层面的问题。

抛砖引玉,笔者希望能进一步繁荣业内大型医院信息化 IT 治理建设的理论,推动业
内综合性医院信息化建设的共同发展。

关键词：综合性医院；医疗信息化； IT 治理；策略；ABSTRACT
In recent years , China's health system has been continuously deepened,
medical and health services gradually toward standardization direction.
The Government has proposed a health information technology focused on
35212 Project in theTwelfth Five Year.In this program,China will focus
on building national-provincial-municipal health information platform ，
Strengthening information applications in public health、medical services、
NCMS、 the basic drug system、integrated management， building two basic database
of electronic health and medical records，building a dedicated network of health
information ，and gradually building information security and standard system.
With the development of the health care reform and the demand of medical
services,more and more large general hospital going to build a new school
district, or municipal mergers and consolidation of some specialized hospitals,
local hospitals. Therefore, the Group of Hospitals and administrative systems
within the same set of multi-hospital area gradually become a new development
in trend.
How to solve the new emerging problems in the information construction of
large medical institutions is an urgent issue.
In this paper, We discuss the development situation of information
construction in Z hospital,and use IT governance framework model to analyze its
problems in the field of requirements, application systems, information security,
risk management, organizational management at first.Then,we use interview and
causal analysis method to investigate the cause of the problemn in the field
of decision-making , motivation , it control and external environment, and use
the questionnaire survey to dicuss the cause of the problem in-depth analysis
and testing.
At last, we dicuss on the IT governance strategy of the information
construction in Z hospital based on the theory of IT governance.
Summary, I hope to further the prosperity of the hospital information