導入資訊系統於醫院急診流程之效益評估研究

Abstract

有鑑於目前全球人口老化的趨勢，對於醫療資源的需求以及如何有效運用日趨迫切，而在所有醫療資領域中，又以急重症單位所面臨之挑戰最為嚴峻。其中牽涉到醫療資源的不足、醫護素質的參差不齊、醫病關係的不對等以及醫療網絡的整合不完全等等，都使得急重症醫療領域面臨挑戰，亟需導入臨床資訊系統來加以改善目前醫療環境所面臨之問題。 本研究希望探討臨床資訊系統之內涵以及導入臨床資訊系統於加護病房所帶來之效益。利用波特價值鏈模型為架構，探討目前急診流程所面臨之挑戰，以及在系統導入後，可以因流程改善而帶來之效益加以分析，並以針對相關人員做專案訪談，提供護理人員、病人、醫師之專業意見回饋。以質化及量化之數據，證實在臨床資訊系統導入後，分別在人力資源效能、醫療品質，病人滿意度以及流程簡化四部分，都有得到實質的效益提升。 最後，在本研究後續討論中，我們希望不管是在持續追蹤系統導入對流程改善與組織效益的發展狀況，或是未來將資訊系統擴大運用至所有臨床單位，甚至是結合資訊與通訊科技，將醫療服務延伸至居家照護等願景，都能達到打造超越國界與時空之雲端醫療環境的終極目標。

Due to global trend of aging population, the demand for medical resources and how to effectively use it is getting increasingly urgent. Among all health care fields, critical care and ICU are two units facing the greatest challenges, including insufficiency of healthcare resources, uneven healthcare quality, unequal relationships between physicians and patients, and incomplete integration of the healthcare network and so on,. It therefore becomes urgent to evaluate the costs and benefits of implementing a clinical information system to improve and solve the problems in the healthcare environment. The purposes of this research are to discuss the concept and reality of a clinical information system and to analyze the benefits of implementing clinical information systems in ICU. Guided by Porter's value chain model, this research is able to explore the current challenges in emergency procedures of ICU, and the differential benefits of ICU procedures after implementation. Moreover, for project-related members such as nurses, patients and physicians, their professional opinions and feedbacks are interviewed as well. Based on the qualitative and quantitative data, for parts respectively in the human resources efficiency, quality of healthcare, patient satisfaction, as well as procedure streamlined are found to be improved. Future endeavor based on our initial findings can be made on examining the benefits of system implementation and the improvement of the organization, or expansion of the implementation of clinical information systems to other clinic units, even more applications of combination of informatics and telecommunication techniques in healthcare fields to extend the services to homecare, among others. We hope that an ultimate goal of being a cloud environment without boundary for healthcare can be realized soon.