隨著高齡少子化趨勢，人口結構開始加速老化，加上現代人生活型態改變，各式疾病發生年齡急遽下降，造成人民醫療費用的負擔逐漸增加，因此醫療照護之需求轉為治療與照護並重。其中心血管疾病照護與預防的需求越來越受到重視，但是國人對醫院及醫生高度依賴，造成了大量消耗醫療資源與社會資源的不良影響，因此醫界試著與國內科技廠商合作，透過資通訊科技的導入應用，發展遠距照護服務，激發出創新醫療服務模式的興起，進而帶動健康照護產業的發展。
然而組織複雜、醫療產業特有文化等背景因素，使得醫療產業在創新服務發展上的速度相對較慢。遠距照護服務模式正處於摸索、起步階段，因此本研究首先利用VISOR Framework 來探討台灣某醫院遠距照護中心的現行商業模式，而在高度競爭的醫療服務產業中，欲保持其競爭優勢以及永續經營，必須建立一套績效評估模式來維持其營運績效與服務品質。因此在探討商業模式之後，將接續建立專屬個案遠距照護中心的平衡計分卡，並且運用系統動力學的概念，繪製出各績效評指標之間的因果回饋環路圖，以補強平衡計分卡所忽略的指標因果關係與時機延遲效果之不足。
在研究結論中，對最終繪製出的因果回饋圖進行分析，對個案遠距照護中心接續的營運建議，並且提出本研究之限制與後續研究建議。

Because of the trend of aging society、declining birthrate, and the lifestyle change, the age of disease incidence is decrease dramatically, cause the medical treatment cost for people is increasing. Therefore, the demand of treatment and care is emphasized equally, especially there is pay much attention tocare and prevent cardiovascular patient. But people is too rely on hospitals, it waste huge medical and society resources, so the hospitals and technology companies try to collaborate, by IT application to develop the Telehealth Service, and to agitate the new service model of healthcare innovation.

However, the innovation speed in medical industry is slower than others because of the complex organization and the special culture background. The service of telehealth is just in the beginning level, so at the first, this study usethe VISOR Framework to discuss the business model, and then develop the Balance Card based on the current practice of a Telehealth Center in Taiwan,and investigate the all KPIs by System Dynamics to build the casual loop in the final step, in order to cope with the BSC has limited ability to deal with the interactions between KPIs and does not consider the effect of time delay.

Based on the results of the casual loop, provide some suggested about the performance evaluation and the business activity for the Telehealth Center.

謝 辭 ................................... I
摘 要 ................................... II
Abstract ................................ III
目 錄 ................................... IV
圖 目 錄 ................................ VI
表 目 錄 ................................ VII
第一章 緒論 ............................. 1
第一節 研究動機 ......................... 1
第二節 研究目的 ......................... 2
第三節 研究方法 ......................... 2
第四節 研究流程 ......................... 3
第二章 文獻探討 ......................... 5
第一節 服務創新 ......................... 5
第二節 商業模式 ......................... 8
第三節 遠距照護 ......................... 15
3.1 遠距照護的發展歷程 .................. 15
3.2 遠距照護的定義與特性 ................ 17
第三章 研究理論架構 ..................... 19
第一節 VISOR Framework .................. 20
1.1 價值主張 (Value Proposition) ........ 21
1.2 互動介面機制 (Interface) ............ 23
1.3 服務流程平台 (Service Platforms) .... 27
1.4 組織結構 (Organizing Model) ......... 29
1.5 成本效益模型 (Revenue/Cost Model) ... 31
第二節 績效評估工具－平衡計分卡 ......... 33
第三節 績效評估工具－系統動力學 ......... 35
3.1 系統動力學應用於平衡計分卡 .......... 38
第四章 個案討論與分析 紹 ................ 39
1.1 個案遠距照護中心發展沿革 ............ 39
1.2 個案業務概況 ........................ 40
1.3 台灣各大醫院遠距照護服務比較 ........ 41
第二節 個案商業模式探討 ................. 43
2.1 個案遠距照護中心之價值主張 .......... 43
2.2 個案遠距照護中心之互動介面機制 ...... 46
2.3 個案遠距照護中心之服務流程平台 ...... 49
2.4 個案遠距照護中心之組織結構 .......... 52
2.5 個案遠距照護中心之成本效益模型 ...... 56
第三節 個案面臨之挑戰與討論 ............. 62
3.1 個案遠距照護中心收案阻礙 ............ 62
3.2 個案遠距照護中心個案續約率挑戰 ...... 64
第五章 個案商業模式之績效評估 ........... 67
第一節 個案之平衡計分卡建構 ............. 67
1.1 財務構面 ............................ 68
1.2 顧客構面 ............................ 69
1.3 內部流程構面 ........................ 71
1.4 學習成長構面 ........................ 73
第二節 個案之系統動態環路圖建立 ......... 74
第六章 結論與建議 ....................... 87
第一節 結論 ............................. 87
第二節 研究限制與未來研究方向 ........... 89
參考文獻 ................................ 91

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