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Top1. Introduction
Information communication technologies (ICTs) have infused the world, in almost every industry sector and many daily lives, over the past two decades. Technological innovations are also being adopted by the complex health care sector, particularly in large hospitals for improving efficiency. The research reported in this paper is situated mainly in the ‘emergency’ areas of hospitals, and related interconnected areas, within two large hospitals of Australia, where a relatively new Radio Frequency Identification technology (RFID) was implemented for process efficiencies.
Australian government is now spending almost $42 billion more on health in 2013 than they did a decade ago (McGowan, Gregory & Atkinson 2013). In Australia, the Medicare system provides free access to Public Hospital services and assists with the costs of a range of medical services. While the Commonwealth government has the role of developing policies, research funding, national and international health issues, State and Territory governments manage public health services, deliver public acute care, psychiatric hospital services, community care and public health. Majority of doctors and allied health professionals are self-employed, Private Hospitals are owned by both profit and not-for-profit organisations (Whetton 2005; Whetton & Georgiou 2010). In 2013, The Ministry of Health and Ageing, a Commonwealth government department (Healthgov 2013), started to administer national health policy at the federal level. The Commonwealth government provides about 70 per cent of health sector finance (Duckett 2007; Duckett & Wilcox 2011). The other 30 per cent is made up from funding agencies and not-for-profit organisations that service hospitals.
In recent years, Australian hospitals have introduced medical technologies such as radiological scanners and biological therapeutics, which have increased the costs of health care to average citizens (Novak & Judah 2011; Productivity Commission 20061). Some studies in the latter half of the last decade in Australia (Productivity Commission 2006, Gabbitas & Jeffs 2007; Novak & Judah 2011) indicate considerable variation in hospital costs across Australia, with scope for significant improvements in efficiency. Historically in Australia, the legal environment has restricted technology implementation within hospital environments, particularly innovative technologies (Crompton 2002; Duckett & Wilcox 20112). The rationale ranges from provisions in the Privacy Act (1988) to hospitals’ in ability to bear the upfront costs of implementing innovative technologies. While working in a regulated environment of hospitals, technology needs economic viability for long term sustainability (Cavoukian 2008; Productivity Commission 2006).
Conversely, Public and Private Hospitals in Australia traditionally have used different criteria for assessing new technologies (Duckett 2007). This unbalanced approach has encouraged the interplay between legacy3 systems and innovations (Duckett & Wilcox 2011). While Private Hospitals are burdened with the costs of deploying ever-changing technologies, Public Hospitals (often large hospitals) have to obtain funding and acceptance by government departments (Novak & Judah 2011). As a result, large hospitals are often reluctant to trial an innovation that may not integrate smoothly into their framework.