台灣中小型診所經營管理系統創新整合服務―以OPHI系統為例

Abstract

由於人口快速老化、對醫療服務與藥物的需求漸增以及醫療成本提高，造成健保收入及支付方面逐漸失衡，健保給付費率大幅刪減，使得醫院及基層診所給付點數逐年下滑；醫藥分業及總額預算的精神，再使得診所經營雪上加霜，為醫療院所永續經營帶來不小的壓力。再加上，近年來，醫療糾紛鑑定量逐年上升，造成社會整體醫病關係緊張。而自2016年起，新政府實施「一例一休」勞工工作日數改革政策後，使得台灣中小型診所的開業醫師面臨的診所管理與經營漸趨複雜。本研究旨在透過資訊科技的應用，協助醫師善用有限的時間與空間，優化作業流程，提高品質與效率，同時，滿足員工與顧客的滿意度，並達成財務平衡，進而最大化診所利潤與效用。本研究以中小型診所之開業醫師為研究對象，以問卷方式，探討目前診所的經營，並透過顧客痛點與價值主張分析，輔以營運模式規劃，提出適用於台灣中小型診所之經營系統整合創新服務與營運模式。依據人力資源調度、醫療糾紛處理、財務管理與報帳計稅面向，分析台灣中小型診所當前普遍面臨之經營痛點方面。本研究進一步提出OPHI創新整合服務，以提供台灣中小型診所全面性的經營管理服務系統與支援。OPHI服務將人事管理由繁化簡，提供雲端整合財務稅務，並有專人處理醫療糾紛，使得診所經營企業化。總結而言，本研究透過問卷方式，探討目前診所的經營，並透過顧客痛點與價值主張分析以及商業模式規劃，對未來的台灣中小型診所之經營系統整合創新服務做出貢獻。

The increasing aging population and demand for medical services and drugs, as well as rising medical costs result in gradual imbalance in health insurance income and payment. Healthcare payout rates have been significantly reduced, making hospitals and primary clinics’ pay-points go down year-by-year. The total budget constraints make the operation of the clinic worse, and brings a lot of pressure to the sustainable management of the hospital. In addition, in recent years, the number of medical disputes has been increasing year by year, which has caused a strained relationship between doctors and patients in society as a whole. Since 2016, the implementation of the labor reform policy has also made the management and operation of clinics in Taiwan increasingly complex. This study aims to optimize the operation process, improving quality and efficiency through the application of information technology, and at the same time satisfying the satisfaction of employees and customers, and achieving financial balance, thus maximizing clinic profit and utility. In this study, the doctors of small and medium sized clinics were studied. The questionnaires were used to discuss the operation of the current clinics. Through the analysis of customer pain points and value propositions, and in conjunction with business model planning, an innovative and integrative operation and management system service for small and medium-sized clinics in Taiwan is proposed. In summary, this study contributes to the integration and innovation of business systems in Taiwan’s small and medium-sized clinics.