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標題: | 醫師於健保醫療資訊雲端查詢系統影像調閱現況分析與需求探討 An Analysis on the Current State of Physicians' Access to Images in NHI MediCloud System & Investigation into Related Requirements |
作者: | 楊思暉 Szu-Huei Yang |
指導教授: | 郭年真 Raymond N. Kuo |
關鍵字: | 影像調閱,影像共享,健保醫療資訊雲端查詢系統,醫師, medical image access,medical image sharing,NHI MediCloud System,Physicians, |
出版年 : | 2023 |
學位: | 碩士 |
摘要: | 研究背景:電子病歷為醫療資訊之基石,多年來電子病歷共享對提升病人安全及提高病患滿意度有所貢獻,而病歷分享不僅為文字,醫療影像更是重要的一環。健保署於民國107年啟動醫療影像上傳與調閱政策至今逾5年,印證高價影像檢查如電腦斷層(CT)及磁振造影(MRI)之重複檢查明顯下降,因而減少健保支出。
研究目的:期透過本研究了解醫師對於「健保醫療資訊雲端查詢系統影像調閱瀏覽器」之使用現況分析與潛在需求。 研究方法:運用質性研究,以半結構式個人深度訪談(in-depth individual interview)方式,透過內容分析法(Content Analysis)執行資料分析與歸納,作為本研究結論。 研究結果:本研究共收案19位不同科別及醫療機構層級醫師,多數醫師因為「診療需求與診斷確認」而進行調閱,調閱頻率最多落於100診療人次約20-30次;CT及MRI仍為被調閱最多的影像,種類會因科別不同。針對影像與報告之重要性與參考價值上,多數內科系及急診一致認為報告重要性高,多數外科系醫師認為影像價值高,唯耳鼻喉科及神經內科醫師較不一致,因個人看診習慣有異。大部分醫師給予此平台70-80分之評價,但仍重視以下議題包括「影像或報告不完整」、「影像品質不一」、「系統功能與UI問題」、「連線/網路品質問題」…等。醫師認為此平台對於醫療體系之貢獻,包括「降低醫療資源浪費」、「提升診斷即時性」,以及「提高診療精準度」。而對未來延伸需求最重視「AI輔助相關需求」,亦為現今熱門議題仍多被醫師提及。 結論:「健保醫療資訊雲端查詢系統影像調閱瀏覽器」對於台灣整體醫療貢獻不容小覷,尤以減少醫療資源浪費、提升診斷即時性與精準度上,普遍受醫師們肯定,也因此對於醫病關係有所改善且讓醫療品質與病人安全獲得提升。 Background: Electronic medical records serve as the cornerstone of medical information. Over the years, the sharing of electronic medical records has made significant contributions to enhancing patient safety and increasing patient satisfaction. Medical record sharing is not just limited to texts as medical images are equally important. It has been more than 5 years since the National Health Insurance Administration initiated the policy for uploading and accessing medical images in 2018. The policy has seen a significant decrease in the number of repeated high-cost imaging examinations such as computed tomography (CT) and magnetic resonance imaging (MRI), thereby reducing national health insurance expenditures. Objective: The purpose of this study is to investigate the current usage and potential needs of physicians regarding the "NHI MediCloud Information System Image Access Browser". Methods: Qualitative research approach and the method of semi-structured in-depth individual interviews are employed to conduct data analysis and induction via content analysis to reach a conclusion for this study. Results: This study included a total of 19 physicians from various medical specialties and healthcare institution levels. The majority of the physicians accessed the system primarily for "clinical needs and diagnostic confirmation," with most physicians accessing medical images 20-30 times per 100 patient cases. CT and MRI images remained the most frequently accessed images, with different medical specialties opting for different types of images. Regarding the importance and reference value of images and reports, physicians in internal medicine and emergency medicine unanimously considered reports to be highly important. However, surgeons tended to place a higher value on images. There were some inconsistencies among otolaryngologists and neurologists, which may be attributed to individual clinical habits. Most physicians rated the platform a 7 or 8 out of 10, but raised concerns about "incomplete images or reports," "inconsistent image quality," "system functionality and UI issues," and "connection/network quality problems." Physicians acknowledged the platform's contributions to the healthcare system, including "reducing medical resource wastage," "enhancing diagnostic immediacy," and "improving diagnostic accuracy." When it comes to future expansion, physicians emphasized a strong interest in "AI-assisted functionalities," reflecting the current trend and ongoing discussions within the medical community. Conclusions: The "NHI MediCloud Information System Image Access Browser" has made significant contributions to the overall healthcare system in Taiwan. It is generally recognized by physicians for its impact on reducing medical resource wastage and enhancing diagnostic immediacy and accuracy, which has led to improvements in doctor-patient relationships as well as an overall enhancement of healthcare quality and patient safety. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/91869 |
DOI: | 10.6342/NTU202304569 |
全文授權: | 同意授權(限校園內公開) |
顯示於系所單位: | 健康政策與管理研究所 |
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