The document provides a case study report on Alexandra Hospital and how they have leveraged experience design to transform healthcare services and provide quality and affordable care. It discusses how the hospital implemented an enterprise system by integrating different departments and technologies like the Clinical Digital Dashboard and Bed Management System. The integration allowed for real-time sharing of patient information and bed availability across departments, improving workflow and reducing waiting times. The implementation involved selecting appropriate package software, addressing critical success factors like user inclusion and identifying key performance metrics to measure benefits. The successful transformation demonstrates how technology can be used to improve healthcare processes and the patient experience.

1. CASE STUDY
RESEARCH REPORT
ALEXANDRA HOSPITAL
2013
Swinburne University of Technology
4/28/2013
Han Chen 1728709
Kathy Tovar 2090899
Joshua Chu 9720332
Kagure Muriithi 2044005

2. EXECUTIVE SUMMARY
The report aims to provide information base on the case study Alexandra Hospital
(AH).In particular, the study case is focus on how the process of innovation has
successfully leveraged on experience design to transform AH and provide good and
affordable basic medical to patients.
AH is a medical centre that delivers consistent, excellent quality care and services in
order to build a healthy nation. For the purpose of this analysis different sections
have been described. The first section will give and introduction to the case study
and overview of the AH. The following sections are referred to the applicability of
technologies in relation to the improvement of health services towards hassles-free
vision. Ideally, this will describe in a very detail how the AH transformed healthcare
services with technology fully exploited. Enterprise system (ES) will be associated
while describing the process of change realised by the existing team of AH. Finally, a
summary and conclusion will be mentioned as part of the learning outcome.

3. TABLE OF CONTENTS
EXECUTIVE SUMMARY ...................................................................................................... 1
REPORT INTRODUCTION................................................................................................... 3
ORGANIZATION OVERVIEW............................................................................................... 3
ENTERPRISE SYSTEM IN RELATION TO CASE STUDY................................................... 4
BUSINESS OBJECTIVES..................................................................................................... 5
PACKAGE SOFTWARE ....................................................................................................... 7
ENTERPRISE SYSTEM SELECTION CRITERIA ................................................................. 8
CRITICAL SUCCESS FACTORS OF ES.............................................................................. 9
SAP BUSINESS ELEMENTS.............................................................................................. 11
CULTURE ORGANIZATION............................................................................................... 12
EPC DIAGRAM................................................................................................................... 13
EXTENDED ENTERPRISE SYSTEM ................................................................................. 15
SUMMARY & CONCLUSION.............................................................................................. 16
REFERENCES ................................................................................................................... 17

4. REPORT INTRODUCTION
This Case Study report is on the Alexandra Hospital and how they have attempted to
create a primary position in the health industry in Singapore. The Alexandra hospital
prides itself in the exceptional service it provides to its patients and how it aims to
provide safer and better quality medical environment in the industry. The modern
hospital, according to Alexandra Hospital, 2010, lies in approximately 100,000
square metre lands and was begun in 1938 with about 500 bed capacities
(Alexandra hospital, 2012).
Public entities of the 21st
century have realised that it is time to position themselves
and change lest they lose to their competitors. Alexandra Hospital has realised that
the only way to do this is to do it through employing innovative IT solutions into its
operations. They have also realised the most economical and relaxed way to do this
is by integrating different hospital departments to churn hospital traffic while using
minimal effort.
This report will focus on Alexandra Hospital’s integration of Business enterprise
systems including the formation of the Clinical Digital dashboard in conjunction with
the Bed management System (BMS) as extended systems. The report will provide
analysis based on questions asked and suggestions that the Hospital may benefit
from in the implementation of the system. The major concept involves the integration
of the enterprise system, its benefits, disadvantages and success factors. We will
see how best practices can be adopted to deliver effective and efficient quality
service.
ORGANIZATION OVERVIEW
The Alexandra Hospital (AH) was originally established in1938 as a British Military
Hospital in Singapore. This was an institution that embraced modern medical
technology right to the 1970s. In 1971, the original hospital was passed to the
governmental authorities of Singapore for a sum of $1 and was renamed as
Alexandra Hospital. During the same year, it was officially opened to the general
public. The AH had undertaken a remodel in the year 2000 and came to be an
associate of the National Healthcare Group (NHG). After the major restructure, its
medical facilities and services have been constantly upgraded in order to provide a
better standard of quality services towards a hassle-free. A new health center was

5. opened in Yishun and named Khoo Teck Puat Hospital (KTPH) on May 2007. The
team member responsible for running the new medical centre was comprised by
existing team in AH. The following year, the KTPH and AH were joined together and
formed Alexandra Health with the restructuring.
AH has been managed by Jurong Health since August 2010 until the completion of
Jurong General Hospital by the end of 2014. To date, an extensive range of medical
services and care are still provided by AH.
ENTERPRISE SYSTEM IN RELATION TO CASE STUDY
A. Keywords applied in the case study
Off-the-shelf: It refers to the computer software and hardware that are able to
immediately suit for the requirement of company, or only needs to have slight
changes. Packaged software (off-the-shelf) is standardized and ready-made, in
some situation it might not fit for a particular use.
In this case, one example of the AH’s adoption of off-the-shelf software is the
implementation of Cisco Clinical Connection Suite (CCS) for its bed management,
and using GlobeStar System’s ConnexALL software as the integrative solution to
Cisco IP Telephony system.
Transaction Processing System: Transaction Processing System (TPS) refers to
the basic information system that serves a company’s daily activities. The TPS is
capable to collects, modifies, and retrieves relevant data.
According to the case, Clinical Digital Dashboard (CDD) at the Department of
Emergency Medicine (DEM) is an example of transaction system. CDD records all
patients’ health condition and then displays the data to doctors, enable them
prescribe medication at one go.
Management Information System: Management Information System (MIS) is the
development and use of information systems that help business achieve their goals
and objectives (D Kroenke, 2010).
In this case, the Bed Management Systems (BMS) is a comprehensive solution for
bed management that provides real-time monitoring of bed availability for patients.

6. Common Core Business Processes: Common Core Business Processes refers to
a series of activities that are performed among different department in an
organization in order to achieve their goals. The common core elements are usually
include marketing and sales, accounting and finance, technology support, human
resource management, and supply chain management.
In this case, the hospital delivered an in-time medical treatment through its CDD
system, and when patient require bed, AH’s BMS is able to allocate a vacancy. All
these activities are including the hospital’s sale process.
BUSINESS OBJECTIVES
When Alexandra Hospital started using the enterprise system, the first thing they
may have seen improve may have been the speed of business processes and work
flow. Since most operational and process systems were linked together, information
flow became faster than before. This would have reduced the waiting time of the
patient bed requirement. Also, because the system would link between the
accounting system and cashier counter payment system, all payments would group
the one bill under the patient name, which would only be a click away. He patient
would then evidently be satisfied by the effectiveness of our processes.
The integration of CDD and BMS would mean that operation within the DEM would
move faster which means more lives would be saved per second. As patients move
from DEM to admissions, doctors and nurses would have real-time information on
the patient to follow-up and identify development of patient status. As an example,
this would help in diet; integration with the kitchen, prescription; integration with
pharmacy, close monitoring and care in reference to doctor’s instructions.
In the long –run, patients are expected to be discharged as fast as they were
admitted. There will be no excuse not to give them the best care they need when
they need it. The ease of information access would enable the doctors in the DEM to
quickly share information and efficiently hand-over to ward doctors and staff. This
improves workflow and reduces the chance of accidents and conflicts arising.

7. A. Long Term
Long-term goals according to My Blue-print (2012), are goals to be achieved in the
future. They probably take a year or more. Though they may be difficult to
accomplish, they are often the most meaningful and important measures of success.
 Setting a phenomenal standard for the healthcare industry in Singapore
 Improve the Alexandra hospital environment to ensure quality and safer
medical services
 To exploit value-added activities
 To reformulate old systems of care
 To redesign healthcare services around patient needs
B. Short Term
According to Connick 2013, a short-term objective is a target that can be achieved
between three to six months in the future and is normally easy to achieve. The ones
below apply to the case study;
 To improve work-flow
 To ensure seamless flow of patients to in-patient wards
 To use innovative IT solutions
 To work in synchrony with operation teams
 To increase nurse-patient interaction
 Improve bed turnover
 To increase overall business process efficiency
 To improve overall patient experience
 To reduce waiting time and other administrative processing time
 To capture and store patient information and use it efficiently with ease of
access while maintaining privacy
 Reduce administrative processing time
 To enhance patient services through exploitation of technology
 To maximize communication between parties both external and internals

8. PACKAGE SOFTWARE
A. Advantages & Disadvantages
First of all, off-the-shelf software is a good solution for organizations with
standard business process, as it suits organizations’ own needs. Second,
compared to in-house development, packaged system is generally more
inexpensive and easier for staff training. However, there are several
disadvantages that off-the-shelf system will bring. First, because the designer is
actually outside the company, he might not understand some crucial factors of a
business, and the off-the-shelf system may not wholly suit a company’s special
need. Second, packaged software are not fully tested for a long period, and it
might have the chance to crash during certain situation, which might cause
financial loss of organization, or even worse, casualties. In the case, NYP
(college) student took charge in designing the new system at early stage. If it was
not properly controlled and unprofessionally developed, the hospital could face
the situation of system crashing, losing valuable data, and improperly treatment
of patient.
B. Case Application
According to the case, the hospital needs a new system that allowed doctors to
access to both historical and current data of patients, and reduce their waiting time
and total time spent at Department of Emergency Medicine. To satisfied all the
needs, the hospital has obtained the supports from Fujitsu Asia to implement the
CCS, implemented GlobeStar System’s ConnexALL software, and Cisco IP
Telephony system at the BMU to bridge communication gaps. All of the above
forming of a system seamlessly suit for the hospital’s need.
The reason why AH have not built system in-house is related to its resource
constrains and limitations, from where an important one is the cost factor. Since the
small hospital did not have the financial capability to spend money on a costly ‘in-
house’ system development, collaborating with NYP, the hospital finished all the
work of design, development and deployment of innovative IT solutions, which also
satisfied the hospital’s need with a balance of finance

9. ENTERPRISE SYSTEM SELECTION CRITERIA
A. Criteria
Company: This criterion is referred to choose the adequate Enterprise
System (ES) according to the company requirements and size.
Ease of use: The use of the software should be ease and straightforward.
This will influence in a lower cost of training employees and more efficient
tasks done.
Integration: The ease communication of different systems. More
generally real time enterprise systems are configurable information systems
packages, implemented on-line that integrate people, technology and
information processing. ES software should also give support all areas, must
be complete and integrated. The modules should be configurable for each
task.
Flexibility and adoptability: Evaluate to what extent the needs of the
company are included in the standard, and what parts should be develop out
of this standard. It is more referred to change or adopt a package easily.
Scalability: An ES solution must be prepared in case of the company growth
to scale the solution without a minimum effort, incorporating new modules,
database servers and even new companies.
Security: In a company, there is confidential information that should be
accessed only by authorized personal. For this reason, the system must
implemented different levels of access.
Price: Evaluating the cost of implementation is an important factor for
companies. The associated costs should define what it covers.
Vendor support/ reputation: It is important to assess its strength, historical
evolution and customers.
B. Case Application
Integration
AH required to improve the way of communication between BMU and Ward
13. The type of communication was mainly by static displays and phone calls,
resulting in an increased of waiting time. Another approach was to share real
time information about patient’s information and bed availability. All this was

10. achieved with the integration of the Cisco Clinical Connection Suite (CCS) for
its BMU and ConnexAll program as integrative approach to IP Telephony
system. Fujitsu Asia played the role of system integrator to organize
housekeepers, the ward nurses and BMU to arrange the beds for the admitted
sick person.
CRITICAL SUCCESS FACTORS OF ES
A. Critical Success Factors
Implementation of an enterprise system is successful if it offers all the
functionality that the organisation requires throughout the entire organisation with
minimal effort. According to Nah & Lau (2001), this means that an organisation’s
business processes should integrate with the system’s standard package so that
the business maintains its general strategic vision.
Another success factor is the inclusion of the users in the design and
implementation of the system’s Business process through formal education and
training. This is especially important as it counters resistance to change, one of
the greatest challenges in implementing a business enterprise system. Monitoring
and feedback at this time is important as it helps foresee crises and
nonconformities that may potentially arise in the course of its use.
A third success factor is the identification and establishment of Key Performance
metrics to enable users to gauge the benefits the addition of the system has
brought to them. According to Lee and Lee (2012), targets are important to
monitor progress of any project as they are indicators that the stakeholder’s
expectations have been met. Every organisation should outline key performance
indicators before they implement an enterprise system that they will use to
measure the success of the system on their businesses processes.
B. Case Application
Unfortunately, Alexandra Hospital has not clearly stipulated its system’s success
key performance indicators in this case study. However, we can use its project
objectives to gauge on how successful they have been so far.

11. According to the case study, Alexandra hospital staff participated in the
implementation of the Clinical Digital Dashboard (CDD) by providing input on how
workflow would be improved through the DEM to reduce resource constraints and
maximize value-adding activities. As the staff supported each other and openly
contributed, the system was designed with ease of use that eluded a sense of
familiarity to their former business processes. Suggestions were positive and
effective bearing in mind that the then head of DEM knew what he was doing as
he was skilled in IT.As senior staff had an infectious positive attitude and
cooperation towards learning the new system, it made it easy to learn about and
train lower-level staff and management. Commendable team-work and an open-
minded work culture also greatly contributed to successful implementation of the
system. Consistent and constructive communication was key to Alexandra
hospital’s successful project.
The system managed to reduce patient registration time and consultation.
Through ‘project Phoenix’, Doctors and nurses would operate in synchrony to
reduce out-patient contact time. The more the time reduced and quality of output
was increased, the more successful the system was. For example; according to
Teoh, Pan & Wang (2008), the average waiting time at the DEM was reduced
from 40 minutes to 20 minutes while bed waiting time reduced by 30%. The
system was tested on its ability to increase efficiency of bed turnarounds through
reducing communication between bed allocation teams and reducing effort
needed to prepare a bed for the next patient using real-time information.
Sustainability of this system and increase of client satisfaction or increased churn
of valid hospital admissions and transferrers would be rendered valid key
performance indicators of system success.

12. SAP BUSINESS ELEMENTS
A. Sales Area
Alexandra Hospital delivers only medical service and medicines to its customer,
since there is only one plant of the organization, it is simple to identify the structure
of the whole business. As a medical service provider, AH’s distribution channel is
through all its administration staffs, nurses and doctors. Each of the channels has
specific divisions of free & charged services and products. To sum up, there are five
general product divisions created in the hospital, and under each of them more
specific functions are existed.
Alexandra
Hospital
1000
1000
Direct through
Doctors, Nurses,
Admin staffs
Division 1:
01. Patient
Inquiries
Division 2:
02.
Appointments
Division 3:
03. Ward Services
Division 4:
04. Medical
Treatments &
Nursing
Division 5:
05. Prescription
Medicine
Client
Company
Code
Plant
Distribution
Channel

13. CULTURE ORGANIZATION
A. Organizational & National
Culture has been described by Schein (1985) as the basic assumptions,
values and artefacts which influence how people view the world and how they
behave. Organisational culture plays a critical role in ES implementation
success. Indeed ESs have also demonstrated challenging to implement even
in Western companies, often because of an underestimated requirement for
change management and the repositioning of roles and their meaning for
actors (Boersma and Kingma, 2005). The majority of organisational practices
are affected not only by societal aspects, but also by the considerations
suitable within an organisational sector, public or private. Private
organisations differ from public organisations at three distinct levels-
individual, organisational, and environmental (Heintze and Bretschneider,
2000).
B. Impact of culture on ES implementations
It is often argued that information technologies have the potential to transform
organizations and entire industries (Crowston and Myers, 2004), but the
extent of the ES over the whole company and the challenges of organizational
change required, the ES are distinguished from other information
technologies (Kumar et al., 2002).
Lines (2005) describe the ability to implement new technology, such as
valuation positive or negative which together make the members of the
organization for this initiative. When the perception of an member of the
organization departs from the perception others have on a specific technology
or the technology deviates from the cultural values that has built the
organization, it begins to be conflicts associated with the introduction of this
technology (Leidner, 2010). This causes employees to be more likely to
resist, to oppose, to despise, frustrated and trying to sabotage the change
initiative, causing it to failure, but if instead the employees have positive
attitudes toward the change organizational, they are likely to support and
facilitate the implementation of the initiative, getting a benefit to the entire
organization (Elias, 2009).

14. EPC DIAGRAM
A. AH organization

15. B. Process improvement
Since the Bed management unit will be show states on JIT mode. JIT show
information in real time process. By using JIT will allow staffs know information as
fast as possible. To make the process more affection, consider if the first
consultation doctor already has rights to request a bed unit for patient. System of
Bed management will quicker show up the requirement. Although it only a small
change, however it will improve the environment of working a lot. Manager will have

16. more time to get ready for new place for coming patient and provide better
arrangement.
One of the big jobs in hospital is turnover of new bed unit. Compare with Hotel, hotel
will able to have a better preparation because of the reservation system. However in
hospital normally patient not available to do a reservation since it is accident. The
other way to improve flexible of be management will be put high potential patient on
list. Staff will clearly now up to stage will need almost numbers of bed. And all of it
allows manager easier to manage the bed system and hold bed to people more
serious.
EXTENDED ENTERPRISE SYSTEM
A. Bed Management System(BMS)
This system was used to increase workflow coordination in regard to bed-
space availability. The aim of this system according to Teoh,Pan & Wang
(2008) was to ensure a ‘Just-In-Time’ resource allocation in hospital bed
management that was to result in better turnover for patient beds.
Communication involving patient information through the phone was
minimised while resourceful bed utilization was maximized thus reducing bed
waiting time. By increasing the speed of admission, efficiency of workflow
increased and the hospital was seen more as customer-focused and confident
in their operations. The system was also an integral assistant in future
planning of admissions.
B. Clinical Connection Suite(CCS)
This is an innovative IT solution which utilises the wireless LAN infrastructure
and complements the BMU system to enhance Nurse-Patient interaction.
According to Teoh,Pan & Wang (2008) , this system also bridged the
communication gap between ward 13 and BMU and enabled access to real-
time patient information. Nurses can extract patient’s status through a colour
coded setting as they have patient information available on monitors. The
system enabled nurses to prepare for incoming patients without hustle. In the

17. recent future, Alexandra Hospital may be looking to use the system to
respond to patient movement faster as they milk the technology’s potential.
SUMMARY & CONCLUSION
Alexandra Hospital is a model example of proper enterprise system implementation
using the cheapest existing resource. The organisation has well utilised its staff and
positive work culture to effectively ease their business process and streamline their
workflow. Positive support from technical staff and setting of a good example from
top management has led to great system-human interaction.
We have seen how the good SAP design would enable hospital staff to focus on
what matters more and spend more time with clients. Integrating business systems
and operations has helped to reduce costs and increase efficiency.
We have seen how combining BCM and ccs had brought real-time time information
to easy access helping staff to re-design their work roles to serve clients better. The
collaboration has also lead to the success of several partnerships that would be
helpful; to further develop the entity. We have also seen how the Clinical digital
dashboard maximised use of the limited floor space as to enable access from a
centralised position.
Though only time will tell, as far as we can see, the project looks promising if proper
management continues.

18. REFERENCES
[1]Alexandra Hospital, 2010, Alexandra Hospital, Page viewed April 23 2013
http://www.ah.com.sg/page.aspx?id=125
[2] Connick, W 2013, ‘Setting Short-Term Goals’, page viewed 23rd
April 2013
http://sales.about.com/od/salesplanofaction/a/Setting-Short-Term-Goals.htm>
[3] Lee, SM and Lee, SH, 2012, ‘Success factors of open-source enterprise
information systems Development,’ Industrial Management & Data Systems, vol.
112, no. 7, pp. 1070, Emerald Group Publishing Limited, page viewed April 20th
2013
www.emeraldinsight.com/0263-5577.htm
[4] Teoh, SY, Pan, SL and Wang, P 2008, ‘The Alexandra Hospital: Implementing
Healthcare Information Systems’, Asian IT case Centre, National University Of
Singapore.

19. Swinburne University Of Technology
Faculty of Information and Communication Technologies
ASSIGNMENT AND PROJECT COVER SHEET
Subject Code:_HIT 2416/6416______ Subject Title:_ENTERPRISE SYSTEMS_______
Assignment number and title;__ASSIGNEMENT 1-CASE STUDY REPORT_ Due date:_28TH
APRIL 2013_
Lab/tute group:______ Tutor:__________________ Lecturer:__Phil Joyce__
Family name:________________________________ Identity no:______________
Other names:________________________________
To be completed if this is an individual assignment
I declare that this assignment is my individual work. I have not worked collaboratively nor have I copied
from any other student’s work or from any other source except where due acknowledgment is made
explicitly in the text, nor has any part been written for me by another person.
Signature:____________________
To be completed if this is a group assignment;
We declare that this is a group assignment and that no part of this submission has been copied from any other
student's work or from any other source except where due acknowledgment is made explicitly in the text, nor
has any part been written for us by another person.
ID Number Name Signature
1728709 Han Chen _______HCH________
2090899 Kathy Tovar _______KTP________
2044005 Kagure Muriithi ___KMM____________
9720332 Joshua Chu ___JCH____________
Marker's comments:
Total Mark:__________
Extension certification:
This assignment has been given an extension and is now due on ______________
Signature of Convener:______________________