This paper outlines the journey of a large Australian academic health service in relation to the acquisition, installation and roll out of the REDCap platform (RCP) for the betterment of clinical review (clinical audit 1.INTRODUCTIONThere are a number of challenges facing large healthcare organizations, particularly those where research and audit are key agenda items for the organization.One such challenge is how to balance the operational needs of functional systems and data collections, often tailored to highly specialized health service delivery areas (eg -cardiology versus obstetrics), with a corporate need to save money and provide good information technology (IT) governance, often through standardisation and consolidation. This can lead to tensions between somewhat autonomous business areas and the centralised corporate functions of information management (IM) and IT. In this case study we will examine how our organization set about managing this tension -particularly, but not only, in relation to clinical audit and research needs.Our health service, Alfred Health (AH) [1], has 3 main hospital campuses and several smaller satellite facilities (including psychiatric outreach clinics and a specialised sexual health centre) under its control, as well as many ambulatory services. It also provides state-wide referral services in the areas of adult organ transplantation, adult burns and adult trauma.

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