This study examines the level of clinical sophistication of information technology (IT) in a sample of hospitals in Japan and benchmarks the extent of clinical sophistication in Japan with the findings from similar surveys conducted at different points in time in the State of Iowa in the US and two provinces in Canada. Data for the study were collected using a validated instrument assessing three dimensions of IT sophistication: functional, technological and integration levels. Clinical areas that were assessed include patient management, patient care activities and clinical support activities.