Web 2.0 世代的醫療--資訊導向醫療之趨勢分析

Abstract

近代醫療的進展與醫療知識的累積及散布息息相關。從資訊流向的角度檢視近代醫療的進展有助於從不同的觀點分析整個醫療市場及相關價值鏈。本研究藉著歷史回顧，文獻查詢，論文及期刊資料，網站內容，演講資料等，整理分析並探討近代醫療市場演進的資訊流向及市場衝突因素所在，並將近代醫療的演進與資訊科技的進展作一比較及關連性分析，以及分析近代不同醫療改革階段之醫療決策形成的關鍵因素，目的在於探討資訊流向及資訊不對稱在近代不同階段醫療市場所扮演的角色，並試圖導入Web 2.0網路平等與內容共享的概念作為未來解決醫療市場資訊衝突的可能解決之道。 從本研究由資訊流向的觀點檢視醫療市場，並結合Medtronic/WebMD模式與價值導向醫療產業循環，及加入考量醫療傳承等三個軸向，提出Web2.0醫療平台的模型，亦舉出歐洲脊椎醫學會的Spine Tango計畫與Microsoft公司的Connected Health Framework計畫作為產業實例來說明分析此一觀點與Web2.0醫療平台模型的發展趨勢與限制所在。歸納出結論如下：一、醫療領域的進步與資訊科技的進展緊密相關，探討醫療市場及制度不能忽視資訊流向的問題。二、資訊不對稱是醫療市場效率的主要障礙。三、醫療資訊不對稱及醫療市場的缺乏效率，可以藉著Web 2.0概念在一般醫療知識的散播，專業創新醫療知識的共享，醫療成果的公開顯現，以及由使用者決定資訊價值等方面加以改善。四、Web 2.0概念與價值導向醫療概念的結合，對於全球醫療市場的效率增進及產業附加價值的增加，具有形成良性循環的效果。五、政策法令的限制為Web 2.0醫療的潛在最大障礙。

The history of modern medical evolution is associated closely with accumulation and share of medical information. Inspect medical evolution from the viewpoint of information flow will help us to analyze the whole medical market and value chain. This study retrospect reviews the medical evolution and structure of medical market by information flow among different stakeholders. Through review of literature, website information, business publishes and in comparison with information technology evolution history, this study reviews and discusses the information flow structure, trigger force, and the inefficiency factors of medical market in traditional stage, consumer-driven health care stage, evidence-based medicine stage and value-based health care stage. The objective of this study is to discuss if information asymmetry between different characters in medical market strangulates the market efficiency of medical industry, and with the assistance of information technology development, especially the application of internet and web 2.0 concept, the balance between medical knowledge accumulation and efficient information sharing may exists or not. This study combines the Medtronic/WebMD model, virtuous circle of value-based healthcare mentioned by Michael E. Porter, and considering the medical heritage axis, constructs a hypothetic model of web2.0-platform-centerted health care structure, which is triggered by information flow in the whole health care market. This study also illustrates Spine Tango Project of European Spine Society and Microsoft Connected Health Framework as the development of this trend and the evidences of this model. The conclusion of this study includes: 1. Health care evolves with information evolution. 2. Information asymmetry is the major obstacle of medical market efficiency. 3. Information asymmetry and market insufficiency can be breakthrough with the web 2.0 concept in general information among medical stakeholders, update medical knowledge inside medical professional groups, medical data and results to the publics, and individual evaluation to information by peers. 4. Virtuous circle in health care delivery combines with Web 2.0 health care concept will enhance efficiency and value add-on in global medical market. 5. Legal regulation is still the main constraint.