醫療體系在數位智慧轉型上的實踐探討：眼科醫學中心個案研究

Abstract

本研究旨在探討臺大眼科部作為臺灣領先的眼科醫學中心，在「數位智慧轉型」過程中所面臨的挑戰與機會。隨著全球醫療系統的高度競爭與數位化進展，「數位智慧轉型」已成為提升醫療品質與競爭力的關鍵議題。臺大眼科部在此方面的布局甚早，然其過程中亦面臨諸多問題，這些挑戰不僅涉及科技升級，更涵蓋組織文化變革、資源整合及管理模式調整等。本研究旨在系統性分析臺大眼科部的「數位智慧轉型」現況，探討其挑戰與可能的解決方案，並從商業管理視角提出具體領導策略，以促進轉型成功。 本研究採用「個案分析法」對臺大眼科部進行深入分析，該方法讓我們得以了解該醫療機構在技術應用、管理模式及組織文化變革中的實踐經驗與策略，並分析其如何在資源有限的環境中有效推動「數位智慧轉型」。研究進一步探討轉型過程中面臨的問題與挑戰，並分為「數位轉型」和「智慧轉型」兩大部分。 在「數位轉型」部分，臺大眼科部目前面臨的挑戰主要來自過多的門診病患、擁擠的看診流程、醫護人員短缺及過勞，並伴隨病患的抱怨。此外，傳統「非結構化病歷」須轉型為「結構化病歷，」以提升資料管理效率及跨院區互通性，符合政府期待。然而，技術實施與使用者接受度仍有待克服。基於此，本研究將「數位轉型」分為「門診報到叫號系統」與「結構化病歷」兩部分進行探討，資料來源包括(I)採用「半/非結構式訪談法」訪問十位來自六種職別的員工，及(II)組織內部資料。訪談結果揭示了數位轉型中的具體需求與挑戰，如醫護人員對新技術適應困難、跨部門協作問題，以及技術實施中的資源限制。研究使用PIVOT數位轉型模式、非營利機構管理分析法及C-SOP架構進行分析，以探討臺大眼科如何在資源有限的情況下有效推動數位轉型。PIVOT模型強調數位轉型過程中的靈活性與適應性，鼓勵在快速變化的環境中持續調整策略以達成轉型目標。「非營利組織經營分析法」則從非營利醫療機構的角度，探討如何在資源有限的情況下，有效推動技術創新與應用，特別是在人力與經費受限的狀況下，合理配置資源以實現數位轉型。C-SOP模型提供了系統性框架，幫助我們全面分析數位轉型的各個關鍵步驟，涵蓋從策略制定到執行的全過程，確保轉型策略的落實與持續優化。 在「智慧轉型」部分，臺大眼科部在「偵測式AI」與「生成式AI」領域均有初步成果。在「偵測式AI」方面，除發表學術論文外，謝易庭醫師團隊與宏碁智醫合作的VeriSee Dr網膜病變輔助診斷系統已開發並投入應用。然而，科技進步快速，臺大眼科部仍需加強管理策略來應對挑戰。在「生成式AI」方面，儘管已初步組成團隊並開始嘗試發表論文及應邀演講，仍需商業管理的視角進行策略性經營。研究採用VRIO模式、PEST模式、SWOT模式及「商業模式九宮格」進行分析，這些工具協助臺大眼科部了解其核心競爭力及宏觀環境中的關鍵影響，並分析其如何運用商業策略推動智慧轉型。這些分析方法協助臺大眼科部深入了解自身的核心能力，並掌握在宏觀環境中政治、經濟、社會及科技等方面的關鍵影響，幫助評估這些變化對「智慧轉型」商業策略的影響。同時，這些方法也讓臺大眼科部清楚辨識目前所具備的優勢、劣勢、機會與威脅，並針對智醫產品商品化的挑戰，從商業角度進行策略性佈局，為其未來發展奠定基礎。 透過以上分析，本研究多面向剖析了臺大眼科部在「數位智慧轉型」中的挑戰與未來前景，整合管理模式、組織文化及資源運用後，期待提出具體的領導策略與建議，以推動臺大眼科的未來發展，並為其他醫療機構提供寶貴的「數位智慧轉型」參考。最後，本研究以Kotter 變革八部曲作為總結，期待本研究的成果可以落地執行，真正走入成功變革的階段。

This study aims to explore the challenges and opportunities faced by the Ophthalmology Department of National Taiwan University Hospital (NTUH), as a leading ophthalmic medical center in Taiwan, during its process of "digital and smart transformation." As global healthcare systems become increasingly competitive and digitalized, "digital and smart transformation" has emerged as a critical issue for improving the quality of care and competitiveness. While NTUH Ophthalmology Department has been an early mover in this area, it has encountered numerous problems along the way. These challenges not only involve technological upgrades but also encompass organizational culture change, resource integration, and adjustments in management models. This study seeks to systematically analyze the current state of NTUH Ophthalmology Department's "digital and smart transformation," investigate the challenges and potential solutions, and propose specific leadership strategies from a business management perspective to ensure a successful transformation. The study adopts a "case analysis method" to conduct an in-depth analysis of NTUH Ophthalmology Department. This method enables us to understand the practical experiences and strategies of the institution in technological applications, management models, and organizational cultural change, while also analyzing how the department effectively advances its "digital and smart transformation" in a resource-limited environment. The study further delves into the problems and challenges encountered during the transformation process, divided into two major parts: "digital transformation" and "smart transformation." In the "digital transformation" section, the main challenges faced by NTUH Ophthalmology Department include an overwhelming number of outpatient visits, congested consultation processes, shortages of healthcare personnel, staff burnout, and patient complaints. Additionally, traditional "unstructured medical records" must transition into "structured medical records" to enhance data management efficiency, enable cross-hospital data communication, and meet government expectations. However, challenges remain in terms of technological implementation and user acceptance. Therefore, this study breaks down "digital transformation" into two parts: "outpatient registration and queuing system" and "structured medical records." The data sources include (I) semi/non-structured interviews with ten employees from six different roles within the department, and (II) internal organizational data. The interviews revealed specific needs and challenges in the digital transformation, such as healthcare workers' difficulties in adapting to new technologies, inter-departmental collaboration issues, and resource limitations in technological implementation. The study employs the PIVOT digital transformation model, nonprofit organization management analysis, and the C-SOP framework to explore how NTUH Ophthalmology effectively drives digital transformation under limited resources. The PIVOT model emphasizes flexibility and adaptability in the digital transformation process, encouraging continuous strategy adjustments in rapidly changing environments. The "nonprofit organization management analysis" examines how to effectively promote technological innovation and application in nonprofit healthcare institutions, especially in situations with limited financial and human resources. The C-SOP model provides a systematic framework to comprehensively analyze the critical steps of digital transformation, covering the entire process from strategy formulation to execution, ensuring the successful implementation and continuous optimization of transformation strategies. In the "smart transformation" section, NTUH Ophthalmology Department has made initial progress in both "detective AI" and "generative AI" sections. In the "detective AI" section, in addition to publishing academic papers, Dr. Hsieh Yi-Ting's team has collaborated with Acer Healthcare on the development and implementation of the "VeriSee Dr. Retinal Disease Detection System." However, as technology advances rapidly, NTUH Ophthalmology Department still faces significant challenges and needs to strengthen its management strategies to keep up with the pace. In the "genertive AI" section, although the department has formed a preliminary team, attempted to publish papers, and accepted invitations for lectures, it still requires strategic management from a business perspective. The study applies VRIO, PEST, SWOT, and the Business Model Canvas to analyze the department's core competencies and the key impacts of the macro environment, including political, economic, social, and technological factors, as well as how these changes affect the business strategies for smart transformation. These analytical methods help NTUH Ophthalmology Department to clearly identify its current strengths, weaknesses, opportunities, and threats. Moreover, they provide insights into the commercialization challenges of smart medical products and offer a strategic business layout for future development. Through the above analyses, this study provides a comprehensive examination of the challenges and future prospects of NTUH Ophthalmology Department in its "digital and smart transformation." By integrating management models, organizational culture, and resource utilization, the study aims to propose specific leadership strategies and recommendations for promoting the department's future development, and it offers valuable references for other medical institutions undergoing "digital and smart transformation." Finally, this study concludes with Kotter's Eight Steps for Leading Change, hoping that the findings can be effectively implemented and truly progress into the stage of successful transformation