醫療服務價值創新和社會責任:以台大醫院兒童醫療大樓營運分析之個案研究

Abstract

面對全球人口老化與少子化已對人口結構帶來重大的改變，可以預見醫療照護的需求將急速成長,但是健保的低給付和財務隱憂已對醫界造成重大衝擊。此外，新醫療科技的引進、民眾醫療需求的增加，及重大傷病的增加;使得健保的支出更加龐大. 醫療的藍海應是以創造病人的最大價值為目的，而價值所指的是每一分錢所換得病人的康健結果;因此醫界應該致力創造出高價值的醫療照護系統。 兒童是未來的主人翁,也是社會的棟樑; 有健康的兒童,未來才能成為社會健壯的中堅份子; 因此兒童的醫療保健在現今愈顯重要.照顧弱勢為輿論關切議題,也是衛生署重要政策方針. 臺大醫院兒童醫療大樓提供創新性整合醫療服務,符合行政院衛生署 Health for All的策略目標. 本研究以行政管理的角度分析目前臺大醫院兒童醫療大樓的門診營運狀況，即在深入研究醫療健康服務產業的創新性創業管理及醫療保健業的社會責任. 論文撰寫架構分五部份，第一部份介紹研究背景、動機及目的；第二部份文獻探討，敘述醫療產業環境、醫療價值創新與藍海策略、整合醫療與全人照護、醫學中心的社會責任的相關文獻報告；第三部份確定研究方法、步驟；第四部份提出個案分析；第五部份究結果進行討論、提出改進建議，並闡明未來持續改進方向。 談醫療服務產業的創新管理,不免要捨棄傳統醫療照護走向管理式醫療整合(策重專業整合和後勤支援, 提高行政效益); 確認關鍵資源(頂尖專業人才技術) 和流程再造, 才能穩紮穩打, 勝卷在握. 創新健康服務模式必須具備幾個特點---高度整合的專業醫療包括:(1)工具整合 (2)專業整合 (3)平台整合. 期待讓創新真正成為競爭利器: 唯有形塑永續發展的核心竸爭優勢; 發揮人才優勢, 凝聚獨特價值的經營理念, 才能為組織能創造綜效; 以致於特色競爭者難以模仿, 所以不易取代(Porter,M.E.,2008). 本研究分析一個創新的醫療商業模式,敘述創新性整合醫療服務；具有市場利基的差異化服務產品;為 1)高度資源整合, 並提供 2)病患加值服務. 兒童醫療大樓醫療的服務特色為: (1)整合一流兒童醫療團隊 (2)加強兒童重症醫療服務 (3)婦幼及兒童全方位照護(從母親、不孕、 基因篩檢、 胎兒、 生產、 新生兒、 嬰兒到兒童長大都有專科醫師照護) (4)設置早期療育聯合門診中心 (5)專為兒童考量打造專業空間設計 (6)公共藝術作品點綴兒童候診室,遊戲區等專屬主題空間,讓醫院像美術館. 創新要有目的, 有系統, 嚴密的步驟來執行產業競爭力與轉型. 創新是可依循有系統的方法規劃,也可以用工具檢視的.例如運用創新12 心法來評估.同理創新也可依循有系統的方法規劃:例如從創新雷達四大主軸 4W (What、Who、Where、How) 切入偵測創新的構面( McGahan, 2004; Hamel, 2006). 創造病人的最大價值並同步追求差異化與高品質, 兒童醫療大樓能締造病患, 醫學中心, 醫護和國家的四贏哲學(value creation).我們試圖在少子化的年代趨近父母重視兒童醫療及對重症兒童的醫療臺大醫院責無旁貸的使命.剖析本個案價值創新的層面包含:A) Profession專業創新服務B) Portfolio 一站購足的套裝就醫組合 C) Price平價超值 D) Potential潛在空間(市場,獲利)及服務對象的健康提升;吸引尚未消費的顧客, 擴大已消費者的需要. 最後提出建議事項並歸納結語與願景: (1)醫療創新創業為現今艱困的醫療環境不可避免的趨勢 (2)醫療保健企應善盡社會責任, 重視強化管理制度提昇業內和業外收入以成為永續經營的醫界典範; 並適度切入醫院行銷及醫療慈善募款,以因應產業困境及激烈競爭並確保永續經營是刻不容緩的議題.

Currently, the decline of fertility rate and aging of people are two major worldwide trends. Since these two major trends have changed the people structure in the country, the government and community should focus on such sociomedical issue as early as possible. Although the national health insurance satisfies most of the people, the hidden financial crisis and unreasonable low payment is now the major threat to both the people and the healthcare systems. Moreover, the increasing demands for modern technological medical services for children and the special needs nowadays had made the financial problem worsen in the country. Children today are the masters of tomorrow. They are entitled to our special care and assistance. In the meanwhile, children with special health care needs often require a multidisciplinary team collaboration and integration. The higher the intensity of service, the greater the financial deficit. Nevertheless, Corporate social responsibility (CSR) is now becoming a priority issue in business development, for those who managing a substantial enterprise focused on core competencies or capabilities, the situation remains true in medical service. Together with value creation in innovative medical business model and CSR, only the collaborative integration with profession, platform and process are the key success factors to entrepreneurial business management. There is a very important role for analytical tools and conceptual frameworks to develop executive action plans that can be implemented and communicated to innovative workout. We examined the fundamental skills and analytic techniques that characterize this approach such as: the discipline of innovation, opportunity identification, value capture and refining the business model, systemized organizational process and realistic financial plan---etc. This study is conducted by case study. To correspond to the motivation and purpose of the study, literatures have been reviewed thoroughly. The business model of the case have been verified by the financial, strategic, and competitive analysis. The current status of models and perpetual operation of this case is discussed. The competition advantage and engorging market are the strength and opportunity of the case. The value proposed of the model have been analyzed, evaluated and implemented consecutively. To recognize constrains and advantages, also the possible difficulties for operation and the vision of the future are discussed finally. NTU (National Taiwan University) Children’s Hospital should be encouraged to operate, with governmental and philanthropic support, as a freestanding children’s hospital, so that it may develop and function as an authentic national children’s hospital and achieve its mission of providing quality, quaternary patient care; teaching pediatricians, subspecialists and child health related workers; conducting research on child health issue in Taiwan; and advocating children’s safety and welfare.