Royal Adelaide Hospital: A Case Study

This assignment delves into the Royal Adelaide Hospital (RAH), focusing on its implementation of advanced digital technologies. It examines various aspects, including its role as a digitally-driven hospital, patient care enhancements through technology, and the impact of digitalization on healthcare operations. Drawing upon case studies and research papers, the assignment analyzes the successes and challenges associated with the RAH's digital transformation journey.

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Table of Contents
Part II – Development of Understanding for Business:...................................................................3
Business Situation:.......................................................................................................................3
PEST analysis:..........................................................................................................................3
SWOT analysis:........................................................................................................................4
Business Needs:...........................................................................................................................5
Business Priorities:.......................................................................................................................6
Organization Structure & Capabilities:........................................................................................6
Business Challenges, Risks, and Approaches used to resolve/mitigate those:............................7
IT Challenges, Risks and Approaches used to resolve/mitigate those:........................................9
Processes:...................................................................................................................................10
I.T Infrastructure and Operations:..............................................................................................10
Information Systems and Enterprise Architecture:....................................................................12
Budget and Spending:................................................................................................................13
References:....................................................................................................................................16

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Part II – Development of Understanding for Business:
Business Situation:
The business operations of Royal Adelaide Hospital are affected from various internal and
external factors. PEST analysis and SWOT analysis can be used to analyse the internal and
external factors which are affecting business operations.
PEST analysis:
Political:
 Employment and social legislation in Australia
 Taxation policies on medical equipments (Royal Adelaide Hospital, 2017)
 Protective legislation for consumers and environment
Economical:
 Unemployment across the region
 Labour costs due to globalisation (Royal Adelaide Hospital, 2017)
 Changes in income distribution and disposable income
Social:
 Growth in population
 Changes in lifestyle (Royal Adelaide Hospital, 2017)
 Changes in pharmaceutical prices due to variations in demographic
Technological:

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 Advancement in medical equipments or technologies
 Implementation of electronic records for medical
 Use of cloud services to store patient data (Royal Adelaide Hospital, 2017)
 3-D printing in medical care
SWOT analysis:
Strengths:
 Best facilities for patients to control their privacy, infection or comfort
 Latest innovations in health care with automated distribution system for pharmacy
 Digital tracking system for instruments or equipments (Royal Adelaide Hospital, 2017)
 Effective management strategies for disaster
Weaknesses:
 Overcrowding at hospital premises
 Poor communication within medical staff (Royal Adelaide Hospital, 2017)
 High medical prices
 Inadequate IT support
Opportunities:
 Coordination with leading NGOs
 Development of IT infrastructure (Royal Adelaide Hospital, 2017)
 Improved system of patient safety
Threats:
 Reducing reimbursements

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 Lack of alliances
 Costly services (Royal Adelaide Hospital, 2017)
 Advancement in medical tools or equipments
Business Needs:
From the case, it has been analysed that Royal Adelaide Hospital is focused to provide hospital
and health care services to its patients with integration of central local health network of
Adelaide. The effective implementation of IT within the hospital premises will also enable it to
provide quality and error free medical services at very nominal costs (Government of South
Australia, 2017). On the basis of business needs or requirements of Royal Adelaide Hospital, IT
will enable to implement various important modules in the hospital infrastructure. This mainly
includes,
 Administration system for patients related to registration or discharge process
 Appointment scheduling is related to patient or resource scheduling (South Australia,
2015)
 Financial accounting system to manage business transactions
 Management system for equipments in order to maintain quality and efficiency
 Management information system for nursing related to orders tracking, bed management,
or patient assessment (CIMIC, 2017)
 Information system for laboratory related to medications and setting of inpatient care
 Management system for pharmacy
 Information system for clinical
 Administration systems

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Business Priorities:
The main mission of Royal Adelaide Hospital is to provide quality hospital and health care
services to the patients at affordable prices. The hospital is also incorporated with initiatives
which are economically sustainable in nature by providing innovative medical solutions (South
Australia, 2015). The hospital has effectively implemented vision of leading professionals in
order to incorporate innovative and practical design solutions which easily integrate with modern
technology in the field of health care. On the basis of business needs, priorities for business of
Royal Adelaide Hospital can be defined which are aligned with IT,
 Automated system for pharmacy distribution
 Tele-health facilities to consult at remote location as well (South Australia, 2015)
 Tracking system for instruments or equipments
 Way finding kiosks based on touch screen
 Digital technology for imaging
 Wireless call system for nurse / patients (South Australia, 2015)
 Electronic records for health care
Organization Structure & Capabilities:
From the business needs and priorities, it has been analysed that CEO, CIO, CFO, CHRO, CCO
and customers are the key stakeholders for the Royal Adelaide Hospital.

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(Source: Queensland Government, 2017)
From the above chart, CEO has the responsibility to manage all the health care services of the
hospital. CIO manages the informational system and control IT system of the hospital. CFO has
the responsibility to control and manage overall business transactions (South Australia, 2015).
CHRO manages the staff and adequate doctors within the hospital and always focused to hire
best talent for the organization. CCO handles all the compliance and legislative issues held
within or outside the organization and control the security of hospital premises in effective
manner.
Business Challenges, Risks, and Approaches used to resolve/mitigate those:
On the basis of business operations, different challenges can be faced by Royal Adelaide
Hospital,

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 Financial challenges related to equipments, building, energy costs, staff or consumables
 Reduced rates for reimbursements (South Australia, 2015)
 Challenge of value based reimbursement instead of volume
 Regulatory standards
 Patient satisfaction
 Deal with large amount of data (Mignone et al, 2016)
 Integrated systems within the hospitals
There are various risks witnessed in business operations of hospitals which can be resolved by
effective approaches or strategies.
 Cyber risk can be reduced by implementation of efficient information system with skilled
IT staff
 Healthcare infections can be mitigated by adequate infection controls and adequate
training to the staff (Hunt et al, 2016)
 Privacy or security issues can be resolved with efficient management of health records
 Disaster risks can be mitigated with effective strategies for disaster management
 Technical risks can be mitigated with effective implementation of IT infrastructure within
the hospitals (South Australia, 2015)
 Epidemic risks can be diagnosed with adequate medicines or health care solutions
 Violence activities can be reduced using efficient security staff
 Medical errors can be reduced using effective medical tools or equipments

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IT Challenges, Risks and Approaches used to resolve/mitigate those:
On the basis of business operations of Royal Adelaide Hospital, it can face various major IT
challenges that can affect the operational efficiency of the hospital.
 Increasing costs for IT projects within the hospital industry (South Australia, 2015)
 Increased demand for the data
 Communication gaps within the health care systems
 Inadequate capacity for data storage (De Koning and Andrews, 2016)
 Data privacy
 Health management of population
 Business intelligence with advanced analytics
 Digital system for health
The different risks can be observed in hospital industry which can include,
 Information exchanges of health can be resolved with efficient security framework
 Meaningful use by using adequate audit activities for medical services
 Data warehousing by using efficient interfaces to handle large data South Australia,
2015)
 Biomedical devices need to be secured with reliable patches
 Software licensing can be resolved with regular update of system software
 Network security can be controlled using firewalls or access restrictions
 Prevention of data losses can be treated by using adequate storage devices (De Koning
and Andrews, 2016)

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 Mobile devices need to be managed using effective policies to protect confidential data of
staff or patients
 Shadow IT can be avoided using IT security policies
 Interface issues need to resolved using effective implementation of IT system within the
hospitals
Processes:
The different processes can be categorised in the IT related to business operations of hospitals.
This may include,
 Process to identify the patients using their unique Ids
 Data security process for securing the confidential data
 E-prescription process for the remote patients
 Compliance process to secure the data using rules and policies
 Cloud storage process to record the data on electronic basis
 Automated systems to distribute the pharmacy (Schwalbe, 2015)
 Tracking system process for managing the medical tools and equipments
 Imaging technology process to allow clinical digital images
 Financial accounting process to manage business transactions on online basis using
different payment modes
I.T Infrastructure and Operations:
Information technology of Royal Adelaide Hospital has enabled the hospital to record medical
history of the patients on online or electronic basis. The IT infrastructure of hospital is based on
the cloud technology using which data can be accessed from remote locations as well (Haux et

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al, 2013). Desktop, communication as well as collaboration, mobile apps, platforms, security,
and business process are key elements for IT infrastructure of the Royal Adelaide Hospital.
(Source: Indimedi Solutions, 2014)
The IT operations can be effectively managed by the Royal Adelaide Hospital using various
steps,
 Design and plan stage enables the Royal Adelaide Hospital to design, develop and
optimise support systems as well as business applications, systems and network including
recovery, back up, etc. (Kuperman et al, 2013)
 Build stage enables evaluation of technology, implementation or integration of networks,
development of applications for end users and support systems for the hospitals
 Hosting stage enables to outsource infrastructure of IT using the network provider for the
services (Baird, 2013). This helps to improve the performance level of IT system within
the organization.

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 Operate stage manages all the functions and manages databases or applications, server or
storage systems and network security.
Information Systems and Enterprise Architecture:
The information system of Royal Adelaide Hospital mainly consists of several systems which
enable the hospital to operate its business operations in more effective manner. This mainly
includes,
 Administration system which provide user registration information by which information
of hospital can be accessed effectively from remote location as well. This also describes
the registration and discharge process related to the patients
 Financial accounting system to manage and handle business transactions on online basis
 Appointment scheduling system provides the information related to patient as well as
resource scheduling (Mills et al, 2014).
 Management system for the equipments or tools in order to ensure their quality as well
as efficiency.
 Management information system of nursing that provides information related to bed
management, orders tracking as well as patient assessment.
 Information system of the laboratory provides all medications and settings for inpatient
care (Yoo et al, 2015).
 Management system for pharmacy ensures effective supply of medical facilities to the
patients.
 Information system of clinical provides clinical summary, patient’s lists, medical record
on online basis, etc.

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 Management system of inventory manages purchasing orders for all required resources
for the hospital
 Order management system processes all the information related to the patients in terms
of medication, prescriptions, etc.
The architecture for enterprise defines the conceptual framework for the IT system of Royal
Adelaide Hospital by which IT operations of the organization can be processed in more effective
manner.
(Source: Schweizer, 2013)
Budget and Spending:
The budget is an important section for the business operations in order to effectively implement
or develop new system for the organization (Schwalbe, 2015). The cost for implementation of IT

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system within the organization requires huge amount of investment in order to effectively
process and manage the project.

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(Source: Jax works, 2017)
References:
Baird, A. (2013) The new Royal Adelaide Hospital: the age of the digital hospital dawns in
South Australia. In Proceedings of the Sixth Australasian Workshop on Health Informatics and
Knowledge Management-Volume 142 (pp. 3-6).
CIMIC (2017) Royal Adelaide Hospital. [Online]. Available at: http://www.cimic.com.au/our-
business/projects/new-royal-adelaide-hospital (Accessed: 09 October, 2017).
De Koning, M. and Andrews, J. (2016) Early clinical experience with vedolizumab in the
treatment of patients with Crohn's disease and ulcerative colitis: The Royal Adelaide Hospital
experience. Journal of Gastroenterology and Hepatology, 31, p.138.
Government of South Australia (2017) Australia’s most advanced hospital. [Online]. Available
at: https://s3-ap-southeast-2.amazonaws.com/sahealth-rah-assets/general-downloads/New-RAH-
Most-Advanced-Hospital_Fact-sheet.pdf (Accessed: 09 October, 2017).
Haux, R., Winter, A., Ammenwerth, E. and Brigl, B. (2013) Strategic information management
in hospitals: an introduction to hospital information systems.USA: Springer Science & Business
Media.

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Hunt, J., Holloway, R., Tippett, M. and Kuo, P. (2016) Referral pattern and outcomes of
oesophageal manometry and ph studies: the Royal Adelaide Hospital motility laboratory
experience. Journal of Gastroenterology and Hepatology, 31, p.171.
Kuperman, G., Gardner, R. and Pryor, T. (2013) HELP: a dynamic hospital information
system.USA: Springer Science & Business Media.
Mignone, G., Hosseini, M., Chileshe, N. and Arashpour, M. (2016) Enhancing collaboration in
BIM-based construction networks through organisational discontinuity theory: a case study of
the new Royal Adelaide Hospital. Architectural Engineering and Design Management, 12(5),
pp.333-352.
Mills, S., Yap, K. and Moore, J. (2014) Submucosal dissection has advantages over full-
thickness Tem in selected rectal lesions. A single Surgeon's Tem Series from Royal Adelaide
Hospital, Australia. Colorectal Disease, 16, p.128.
Royal Adelaide Hospital (2017) About. [Online]. Available at:
https://www.rah.sa.gov.au/about/structure-and-governance (Accessed: 09 October, 2017).
Schwalbe, K. (2015) Information technology project management.USA: Cengage Learning.
South Australia (2015) Audit Report. [Online]. Available at:
https://www.audit.sa.gov.au/LinkClick.aspx?fileticket=lKSniN7sYQk
%3D&tabid=283&portalid=0&mid=959&forcedownload=true (Accessed: 09 October, 2017).
Yoo, S., Lee, K., Baek, H., Ryu, B., Chung, E., Kim, K., Yi, J., Park, S. and Hwang, H. (2015)
Development and user research of a smart bedside station system toward patient-centered
healthcare system. Journal of medical systems, 39(9), p.86.

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