| 摘要: | 近年來國內醫療環境急遽變化，為服務更多民眾，並確保醫療費用支付比照原醫院，各醫療院所紛紛建立新院區，其設置地點往往與原院區非常相近。民眾看診通常具有地域性及醫師忠誠性，因此多選擇有距離便利性的鄰近院區看診。雖然衛生福利部已致力於醫療院所電子病歷與醫療紀錄互通多年，但因進度緩慢，難以滿足醫療院所跨院區資訊系統整合需求；所以醫療院所只能自力或委外進行跨院區資訊系統的開發，以期藉由資訊科技的優勢，整合跨院區資源，達到資源最佳配置的目的。
個案醫院是大台北地區內ㄧ所區域醫院，今年度將於總院臨近區域開立新院區。面臨跨院區資訊系統整合問題，需遴選技術廠商所提供之整合架構方案。以往醫療院所之資訊整合決策經驗，大多侷限於成本考量，通常取決於財務數字與直觀經驗。因此借助其他醫院之作法並不可行，而且這些方案遴選資訊多屬醫院內部機密。考慮到國內外文獻在跨院區資訊系統整合決策上的不足，本研究提出一系統化的決策流程以協助個案醫院遴選資訊系統整合架構方案協助。
本研究應用紫式決策方法建立決策架構，並採用多準則決策分析之簡單多屬性評等技術與層級分析方法於跨醫療院區資訊系統之策略整合。藉由對個案醫院訪談與問卷調查，本研究歸納出決策者的評選準則及其權重，以及其決策者在個項準則上的衡量結果。依據以上評量過程，建議個案醫院最佳方案。
In recent years, with the rapid changes and expansion in the medical industry, most medical institutions response with the decision of establishing new hospital branches to serve more people while maintaining the same expense level of patients. The chosen sites for branches are often close one another, and they generally serve the same population of patients. Patients are often territorial and loyal to physicians, and choose the nearby hospital for convenience. Consequently, information integration of multiple hospital branches becomes necessary. Ministry of Health and Welfare, Taiwan, has devoted for years to the integration of the interoperability of electronic medical records and medical institutions; however, the plan of interconnection progresses slowly and is unable to meet the urgent demand of information system integration of cross hospitals. Thus, hospitals can only work out their information integration either through self-development or outsourcing.
The case under study is a regional hospital in Taipei, which is building a new hospital branch in the neighborhood of its current location. Before launching its information system integration plan, the hospital has to determine the system architecture of the integrated information system. The information system architectures of other hospitals are considered as good references to the case hospital; however, it is also noted that the decision made by other hospitals are often based on financial figures solely and sometimes even based on intuitive judgment. Moreover, such decision making process is often the internal confidential documents of hospitals and is not likely to acquire. Due to the limited literature of the decision making process of information integration of cross hospitals, this study aims to formulate a systematic process to assist the case hospital in selecting the best system architecture for cross hospital information integration.
In this study, the UNISON Framework Decision Analysis is adopted as the framework to develop the decision making process of the information system integration of cross hospitals. In which, multi-criteria decision making is used as a strategy formulation tool. Interviews and questionnaire survey are conducted to decision-makers of the case hospitals. The results are used in Analytic Hierarchical Process and The Simple Multi-attribute Ration Technique to determine criteria and their weights and to know decision-makers’ preferences. The best alternative is selected according to this decision-making process. |
