以病人、個管師與平台之協同關係評估遠距照護服務效能 ─以台灣某醫院遠距照護中心為例

Abstract

隨著近年來高齡化社會的出現，健康管理概念逐漸普及，遠距照護服務產業趁勢而起，員工透過智慧平台提供服務給病人，完成「在地養老」的醫療服務，但如何評估這新服務產業的效能也成為一大重點，過去主要以醫療與經濟上的成效作為評估標準，本研究則從內部員工行為出發，透過分析員工、病人與平台間的協同關係，輔以大數據中分析力的描述系統現況，設立一套衡量效能的評估指標。 首先透過潛影觀察與深度訪談來了解案例遠距中心的整體流程，接著繪製服務藍圖來整合員工、病人與系統間的互動，依此設立五大評估指標，分別為「資料量指標」、「使用者指標」、「生理數值處理效能指標」、「忙碌與轉換狀態指標」與「工作項目分配與處理時間指標」五大部分，這些指標能為遠距照護的效能評估帶來相當多的分析價值。 最後依據本研究的指標，蒐集案例遠距中心的平台上數據，貼近實際員工操作情形，可以發現多個特別現象，如生理數值上傳時間主要集中在早上8點至10點間；資料量上以心電圖與血壓的量測項目最多；整體數值的異常比例為3成多，血壓單獨來看卻超過7、8成判定異常；生理數值待確認時間在班別差距不大，但後續待處理到處理完成時間卻在白班花費最久等等，針對這些發現能進行後續的分析與建議，長期觀察數據的變動可做為有效評估效能的方法，因此本研究相信透過這些步驟設計數據指標，了解員工、病人與平台間的協同關係，除了做為評估遠距照護服務功能外，更能改善服務流程與優化系統，對遠距照護服務帶來龐大價值。

The phenomenon of population aging becomes a serious issue in our life. People gradually care more about health management; therefore, telehealth is developed to satisfy those clients’ needs. Clients can upload data and records online everyday by professional measuring instruments. Managers and doctors in the hospital can also monitor the records and provide personalized health advice to clients, improving their personal health. However, how to evaluate the performance of the telehealth? In the past, researchers mainly focused on the effect of economic and disease treatments. The efficiency of the inner process were rarely mentioned. As a result, the purpose of this study is creating indicators to evaluate efficiency by analyzing the collaboration among employees, patients and system. First of all, the study use shadowing and in-depth interview to understand the whole process of the telehealth center case. Secondly, the study use service blueprint to understand the interaction among employees, patients, and system. Based on this interaction, the study creates two main indicators: “Indicator of basic operation” and “indicator of time management and operation”. The former analyzes the correlation among data, employee and patients, while the latter analyzes the task of telehealth such as uploading measurement records, health reports, documents and outpatient attendance. Finally, by these two indicators, the study finds some special phenomenon in the telehealth center case. For example, physical records are often uploaded in a certain period of time. Over 70% blood glucose records are interpreted as abnormal results and the time of processing and finishing is longest in day shift. These analysis results prove that the indicators are useful and potential. Collaboration of employees, patients and system can be a good method to not only evaluate the efficiency but also improve the process and system. The method could be the trend of the analysis on telehealth.