臺灣博碩士論文加值系統

資訊科技不但促成健康照護的發展，也驅動健康照護的變革。對於為何及如何使用資訊科技來協助健康照護，過去已有許多學者詳加探討，並透過實證研究驗證資訊科技或資訊系統的採用，大致符合科技接受模式或資訊系統成功等理論。這些研究結果雖然幫助我們瞭解導入新資訊科技或發展資訊系統的效益，但整體來說，研究概化程度有限，實務應用效果不高，特別是許多先進國家陸續接受與採用新興健康資訊科技來發展全國性的健康資訊系統時，其涉及的議題、面向複雜而多元，過去實證研究提供的觀點，很難幫助全面瞭解現象背後的根本原因及脈絡。
本研究所探討的健保醫療雲端資訊系統，在台灣全民健保單一保險人的制度設計下，已發展為跨醫療服務提供者使用的全國性資訊系統，透過個案研究策略，對於跨組織資訊系統的成功因素可以進行更全面及深入的探討。由於此系統已被廣為接受與持續使用中，因此，本研究藉由多種來源的資料收集，並結合執行科學加以分析評估後，進行系統發展的策略分析及關鍵成功因素探討，希望透過這樣的研究過程，釐清此類日益重要的全國性健康資訊系統的健康資訊交換創新模式，與其成功的根本原因及脈絡，以利後續研究及實務應用。此外，也希望透過本研究的成果，協助學者專家、醫療服務提供者及政府部門，對資訊科技所形成的醫療產業變革，有更深入的觀察與啟發。

Health information technology has been introduced into the health care industry and proved to be an effective solution to current challenges in rising cost and healthcare quality. Taiwan’s National Health Insurance Administration (NHIA) has developed a powerful health information exchange system to share and retrieve not only medication data but also diagnostic medical images to reduce unnecessary healthcare services. This nationwide system offers a great opportunity for health care providers to share medical information on the same platform to enhance medical services for all patients in relation to interoperability and customizability. Our aim is to evaluate the effectiveness of utilization change after the implementation. A case study by using the population based National Health Insurance (NHI) database with other information is conducted in this article.
This study aims to demonstrate the innovative health information exchange model of MediCloud system, an inter-organization information system from implementation science perspective. The empirical findings will be of interest to most countries with a universal healthcare system that are considering implementing a similar health information system that can improve quality of healthcare while reducing costs. Improving patient safety and quality of care is crucial for Taiwan’s citizens, which is also a common goal for most national health systems. Health care providers and NHIA expect great benefits from Medicloud system-based healthcare solutions. The strong positive outcome of MediCloud system encouraged us to further use those new valuable health data plus original claim data to develop various innovative management system and services, and potentially to create a better health care system for people in Taiwan.

目錄
口試委員會審定書 ………………………………………………………………… i
誌謝 ………………………………………………………………………………… ii
中文摘要 ………………………………………………………………………… iii
英文摘要 ………………………………………………………………………… iv
表目錄 …………………………………………………………………………v
圖目錄…………………………………………………………………………viii
第一章 緒論 ………………………………………………………………………… 1
第一節 研究背景與動機 ………………………………………………………… 1
第二節 研究目的 …………………………………………………………………… 4
第三節 研究範圍與限制 ……………………………………………………… 4
第二章 文獻探討 ……………………………………………………………………… 6
第一節 健康資訊交換模式與效益 ……………………………………… 6
第二節 健康資訊科技接受與系統評估 ……………………………… 9
第三節 跨組織資訊系統與開放式創新 ……………………………… 11
第四節 小結：醫療雲端資訊系統發展趨勢 ………………………… 14
第三章 研究方法 ………………………………………………………………… 18
第一節 個案研究 ……………………………………………………………… 18
第二節 資料收集方法 …………………………………………………………… 19
第三節 研究架構 ……………………………………………………………… 20
第四章 研究結果 ……………………………………………………………… 23
第一節 個案推動歷程簡介與架構 ………………………………………… 23
第二節 執行過程與實施成效的分析評估 …………………………… 27
第三節 PEST與SWOT策略分析 ……………………………………………… 37
第五章 結論與建議 ……………………………………………………………… 45
第一節 討論與建議 ……………………………………………………………… 45
第二節 結語 ………………………………………………………………… 50
參考文獻 ……………………………………………………………………… 53
附錄一、健保醫療資訊雲端查詢系統大事記 ……………………… 64
附錄二、健保醫療資訊雲端查詢系統資源與架構 ……………… 67

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