Purpose – The purpose of this paper is to outline a framework for analyzing healthcare process management projects. By using this framework, it seeks to analyze a system implementation in Ireland. The system aims to standardize healthcare human resource and payroll for the Irish healthcare sector. Design/methodology/approach – A popular system and business process implementation is analyzed in Ireland. The research intends to use this case scenario to identify success and failure, which in turn forms the basis to propose a conceptual reference method for introducing healthcare process management. Findings – The healthcare sector has shown that it has, compared with other sectors, a relatively underdeveloped information system structure. In this context, the importance of reducing healthcare costs and streamlining workflows, processes, and care pathways is ever more seriously recognized. However, despite the importance of process management, currently, internationally very few guidelines are provided for introducing healthcare process management in hospitals. Practical implications – The paper provides a good example of a large-scale, nation-wide business process management (BPM) project; shows the different facets of BPM success factors; and helps to raise awareness for both managerial factors and domain-inherent, structural, and content factors. Originality/value – The analysis revealed some interesting results. The reasons for failure in healthcare are rather more content and structural in nature than solely project management issues.