An initiative to set up hospital reference architecture in The Netherlands started over 20 years ago and led to the publication of the ZiRA, the Dutch hospital reference architecture, in 2018. The vision was that with well-functioning hospital architecture, patients and healthcare professionals would benefit from improved IT quality and efficiency and that administrators would be able to manage IT more effectively and IT professionals could introduce innovative applications more quickly. In this chapter, the writers provide an overview of the organization and key artifacts of the ZiRA, give examples of the usage and show the evidence of the added value of the hospital reference architecture. By analyzing whether the goals set 20 years ago have been achieved, this chapter gives an insight into how a reference architecture can contribute to the digital maturity of hospitals and also sets out important attention points and conditions for achieving and maintaining this value. Does this mean that the ZiRA contributes to the digital maturity of hospitals in the Netherlands? As it encourages collaboration and cohesion, the ZiRA has proven to be relevant and valuable and is therefore an interesting instrument to take note of.