- 學位論文
我國醫療諮詢平台設計與營運之影響因素探討-以醫聯網為例
Exploring the Influencing Factors of Online Medical Consulting Platform Strategies and Operation in Taiwan—the Case of MED-NET
摘要
2019年新冠肺炎（COVID-19）爆發，病毒高度的傳染力，使各國開始封城或者限制人民的活動以避免群聚感染，也因此大幅改變人們的行為模式，更催生了各種「零接觸」的需求。而在醫療領域，「遠距醫療」成為疫情期間民眾接觸醫療資源的重要途徑，以減少不必要的外出以及風險，其中醫療諮詢平台打破地理及時間的限制，透過平台模式讓民眾及專業的醫療人員可以直接互動，幫助民眾在就診前後對自己的健康狀況更加了解。然而醫療服務與一般服務具有諸多不同的地方，包括政府高度管制、高度資訊不對稱、治療的不確定性等，使得平台經營者在設計醫療平台時需有不同的考量因素。本研究的主要目的即是探討醫療諮詢平台的設計與營運之重要考量因素。 本研究以國內一間規模最大的醫療諮詢平台做為研究對象，透過質性個案研究的方式，深入訪談平台經營者以及在平台上服務的醫師，以實際瞭解醫療諮詢平台在擬定策略與營運活動時，特別考量的因素，以及其作為對於平台績效的影響。本研究最後所得到的主要結論如下： （1）醫療諮詢平台啟動營運時，會先考量與既有的醫療服務連結，並透過供給端（醫師）與需求端（消費者）的共同演化，來突破「雞生蛋、蛋生雞」的挑戰。 （2）醫療諮詢平台的主要補貼方會是醫師及「一般」諮詢者，尤其著重於前者。而付費方則為「指定」諮詢者，平台在相關的定價上會尊重醫師自行專業判斷的價值而定。 （3）醫療諮詢平台會因服務需求者的目的性，而更加聚焦於專業知識的提供以及與詢問者的互動，以期達到良好的醫病關係。 （4）醫療諮詢平台的知識管理策略，在考量醫療知識複雜性及醫療不確定性等因素之下，會以個人化策略為主，整理化策略為輔。其中前者會強調外部供需媒合的精準度，而後者則會著重於民眾重複問題的探索與歸類。 （5）醫療諮詢平台會透過大量資料的匯聚與學習循環，來創造資訊的網路外部性，並發揮知識管理策略的互補性之效益。 （6）醫療諮詢平台考量到民眾問題的明確度對醫師回覆意願的影響，因而會引導民眾釋放更多的信息，除了提高醫師回覆意願之外，也可以降低醫師診療的不確定性，並提升諮詢服務的品質。 （7）醫療諮詢平台會透過跨域性的運作，來提升醫師科別多樣性、醫師數量及服務品質，並使其成為吸引消費者的關鍵因素。也會透過不同資訊豐富度的諮詢方式之提供，來滿足不同發問者的需求。 （8）醫療諮詢平台的詢問者之問題流量與問題品質以及平台的合法性會是吸引醫師的關鍵因素，而醫師也會藉此營運來滿足其自身的好奇心、公益心、以及建立品牌的企圖心。此外，考量到醫療服務品質對平台口碑的影響，平台也會透過對醫師用戶的過濾機制，來維持平台整體的諮詢品質，並藉由醫師服務的口碑帶動民眾對平台的信任，以增進跨邊的網路效應。 （9）醫療諮詢平台營運的網路效應，除了會受到使用者用戶數的影響之外，也會受到服務品質的影響，因而使得平台經營者會同時重視用戶數、科別多樣性、功能多樣性、回覆速度，以及諮詢品質等兼具質與量的營運考量因素。 本研究最後並提出學術上與實務上的貢獻，以及對後續研究者的建議。
並列摘要
In 2019, the outbreak of the coronavirus（COVID-19）which is highly contagious cause countries to lock down cities and restrict people’s activities to avoid cluster infection. This has also greatly changed people’s behavior and the business of "zero-contact". In the medical field, “telemedicine” that allow people to reduce unnecessary contact has become an important way for people to access medical resources during the epidemic. Among telemedicine, medical consulting platform could break geographical and time constraints, and provide public and professional service providers to interact directly for helping people better understand their health conditions before or after seeing a doctor. However, there are many differences between medical services and general services, including high government regulation, high information asymmetry, and uncertainty in treatment, which make platform operators have different considerations when designing a medical platform. The main purpose of this research is to explore the key factors when designing and operating the medical consulting platform. This study selected one of the largest domestic medical consulting platforms as the research subject, and interviewed with platform operators and doctors in order to understand the factors that the medical consulting platform took into consideration when developing strategies and operating activities. The main conclusions obtained at the end of this study are as follows: （1）During the launch period of medical consulting platform, it will consider to connect with existing medical services first, and make the co-evolution of the supply side （physicians） and the demand side（consumers）to break through the challenge of "chickens and eggs" problem. （2）The main subsidies of the medical consulting platform will be physicians and "general" consultants, with emphasis on the former. The paying party is the consultee who choose the doctor by designation, and the platform’s consultation pricing will respect doctor’s judgement of their own value. （3）The medical consulting platform will focus on the provision of professional knowledge and the interaction between doctors and service demanders who usually have some purpose, in order to achieve a good medical-patient relationship. （4）The knowledge management strategy of the medical consulting platform will be based on personalization strategy, and supplemented by codification strategy by taking into account the complexity of medical knowledge and medical uncertainty. The former will emphasize the accuracy of every matching, while the latter will focus on the exploration and classification of repeated problem among the people. （5）The medical consulting platform will create network externalities of information to leverage the complementary benefits of knowledge management strategies through the aggregation of a large amount of data and learning cycles. （6）The medical consulting platform takes into account the impact of the clarity of the public’s questions on the doctor’s willingness to respond, and will guide the public to release more information, which can reduce the uncertainty of the doctor’s diagnosis and can improve the service quality of consultation. （7）The medical consulting platform will improve the diversity of physician’s divisions, the number of physicians, and the quality of services through cross-domain operation, and make it a key factor in attracting consumers. It will also meet the needs of different questioners through the provision of different consultation methods （8）The key factors to attract doctors will be the amount and quality of users’ question and the legitimacy of the platform. Its way of operating will also satisfy doctors’ curiosity, public-spiritedness, and ambition to build a brand. In addition, considering the impact of the quality of medical services on the brand equity of the platform, the filtering mechanism of doctor users will also be used to maintain the overall consulting quality of the platform. The brand equity of the doctor's services will drive the public's trust in the platform to enhance the positive cross network effect. （9）The network effect of consulting platform operation is not only influenced by the number of users, but also by the quality of service. These may make the operator to optimize the number of users, various divisions, various functions, waiting time, and quality of consultation, which considering both quality and quantity. At last but not least, this study provides both academic and practical contribution, as well as suggestions for follow-up researchers.