The rationale for using a single case study approach is set out and put into context of current case research literature and thinking. The validity of the approach and its implications for being able to generalise from its findings are discussed. The key point in the case is the determination of a private hospital in Auckland, New Zealand, to re-engineer its processes with information technology. Persisting in the face of apathy and even resistance by its main business partners, they achieved a viable pilot system on a minimum budget, using common, off-the-shelf software and technologies. Starting from a modest electronic presence, the hospital’s aim is to become the centrepiece of an electronic community, offering a rich set of communications and other media for the medical practitioners who use the hospital facilities. The case in this chapter is the history of the first service project, an electronic interface for surgeons to book operating facilities and to automate admission procedures. The process changes and improvements are described, as are the resolution of environmental issues such as security and patient privacy. The architecture of the system, which centres on the basic structure of an intranet, is outlined. A number of points of general import for interactive surgeon-hospital systems are developed from the case in conclusion. Pointers for further and/or follow-up research are given.