【正文】 交付之后 ,承包商不再負責建筑的長期使用。在傳統(tǒng)的建筑過程中， 建筑師的酬勞通常是基于項目花費的百分比，這可能僅意味著這個建筑花費的越多，酬勞將越高。 在另一起案件中 ,建筑師可以站在客戶端戰(zhàn)略顧問的角色而不是設(shè)計師。它是為客戶和承包商能有一個公平和公開的合作，使他們都可以最佳利用他們的能力。在綜合采購項目中，顧客只跟建筑施工方保持契約關(guān)系，而與建筑設(shè)計師和承包方之間沒關(guān)系 ( Joint Contracts Tribunal, 2021) 。由于技術(shù)的復(fù)雜性、決策的高水平，從開始直到交付醫(yī)院建設(shè)項目全過程可能需要長達十幾年的時間。 在傳統(tǒng)的采購方法中，建筑師和設(shè)計工程師改進設(shè)計和細節(jié)。這項新政策 旨在刺激醫(yī)療建筑的設(shè)計，采購和管理，這將有助于有效和高效的初級衛(wèi)生保健服務(wù)的可持續(xù)創(chuàng)新。這種變化從國家政策導(dǎo)向方面給與了更多的自由，也分配了更多的責任給醫(yī)療機構(gòu)對其房地產(chǎn)融資和管理。以前，醫(yī)療機構(gòu)根據(jù)醫(yī)療機構(gòu)法（ WTZi）需要獲得新的建設(shè)項目和重大整修許可證和建筑許可證。隨后，通過觀察在荷蘭進行的兩個試點項目，將研究通過 IBM 的應(yīng)用，客戶、建筑師和承包商之間的角色轉(zhuǎn)換。和重新組織的合作進程。在信息傳遞和集成也有其他方面的障礙，例如：許多現(xiàn)有的信息和通信技術(shù)系統(tǒng)不支持的數(shù)據(jù)和結(jié)構(gòu)的先決條件是不同的建筑角色或?qū)W科之間的有效合作的開放性。不同的利益相關(guān)者之間的溝通變得非常重要，因為 每個利益相關(guān)者具有不同的技能。 迅速變化的環(huán)境要求一個建筑在其生命周期中具有靈活性。轉(zhuǎn)移議程、角色和責任的許多建筑相關(guān)人員都積極參與，比如：醫(yī)療保健機構(gòu)，國家和地方政府，項目開發(fā)商，金融機構(gòu)，建筑師，承建商，顧問，設(shè)施管理，設(shè)備制造商和供應(yīng)商。介紹了先進的歐洲研究項目和一些真實的應(yīng)用于醫(yī)院建設(shè)項目 BIM的真實案例。 這種類型的項目很復(fù)雜是由于復(fù)雜的功能與技術(shù)要求 ,做出決定涉及大量的涉眾 ,和長期的 開發(fā)過程。 new contractual relationships。 and reanised collaborative processes. Unfortunately, there are still gaps in the practical knowledge on how to manage the building actors to collaborate effectively in their changing roles, and to develop and utilise BIM as an optimal ICT support of the collaboration. This paper presents a general review of the practical implications of building information modelling (BIM) based on literature review and case studies. In the next sections, based on literature and recent findings from European research project InPro, the framework for integrated collaboration and the use of BIM are analysed. Subsequently, through the observation of two ongoing pilot projects in The Netherlands, the changing roles of clients, architects, and contractors through BIM application are investigated. In conclusion, the critical success factors as well as the main barriers of a successful integrated collaboration using BIM are identified. 2. Changing roles through integrated collaboration and lifecycle design approaches A hospital building project involves various actors, roles, and knowledge domains. In The Netherlands, the changing roles of clients, architects, and contractors in hospital building projects are inevitable due the new healthcare policy. Previously under the Healthcare Institutions Act (WTZi), healthcare institutions were required to obtain both a license and a building permit for new construction projects and major renovations. The permit was issued by the Dutch Ministry of Health. The healthcare institutions were then eligible to receive financial support from the government. Since 2021, new legislation on the management of hospital building projects and real estate has e into force. In this new legislation, a permit for hospital building project under the WTZi is no longer obligatory, nor obtainable (Dutch Ministry of Health, Welfare and Sport, 2021). This change allows more freedom from the statedirected policy, and respectively, allocates more responsibilities to the healthcare anisations to deal with the financing and management of their real estate. The new policy implies that the healthcare institutions are fully responsible to manage and finance their building projects and real estate. The government’s 4 support for the costs of healthcare facilities will no longer be giv