醫院策略聯盟主管資訊系統之建構

邁向二十一世紀，台灣的醫療產業逐步走向市場制，民眾的就醫選擇也多樣化、自由化。健保局為了控制醫療費用成長的情況下，不斷推陳出新的給付方式，醫療院所基於因應保險給付制度的改變、提高內部管理效率、統合人力資源運用、提供更完整連貫的醫療服務等理由，而朝向連瑣經營的趨勢。院際合作的首要條件即是資訊系統整合，以便能即時取得資料。更重要的是藉由此一整合，可將管理制度及作業流程標準化（如成本會計作業及經營分析績效比較、人力資源管理彈性運用、醫院政令推廣及宣導等），以供比較，最高管理決策單位得於制定政策時參考改進。本研究以某醫學大學體系經營之兩所不同型態、任務使命及資訊系統之附屬醫院為研究個案；以資訊時代的管理工具－平衡計分卡的理念，訂定主管資訊系統指標。再依不同的指標建立樣本醫院的資料倉儲及資料方體做為處理個別醫院之主管資訊系統的實體資料。再以方體整合運算方式處理聯盟管理中心的資料處理作業。透過簡易物件存取協定、線上分析處理包裝層、及Office 2000 樞紐分析元件等解決不同資訊系統的資料存取、資料交換及圖型趨勢分析問題。研究結果顯示，透過本系統的建立，聯盟的各成員醫院可以有各自的主管資訊系統，而聯盟的管理中心則有跨平台、多層次的主管資訊系統。經過測試，決策者透過本系統，可快速的取得管理所需的相關資訊，做較正確迅速的決策。本論文研究過程中，對主管決策者和參與系統建構者之管理知識分享及傳承有重要的意義。而主管資訊系統要保有長期的可信度及可用度，必須系統的使用者、維護者、開發者、決策者對醫療環境的變化，有高的敏感度及強烈的參與感。

關鍵字

平衡計分；簡易物件存取協定；主管資訊系統

並列摘要

The medical industry in Taiwan has become market-led in the 21st century. People nowadays have multiple choices to be given medical treatment. In order to control medical expenses, a variety of medical payments have been developed by the Bureau of National Health Insurance. In this condition, more and more hospitals tend to cooperate together to deal with the change of medical payment, to improve management efficiency, to integrate human resources, and to offer much better care for their patients. The integration of information systems between hospitals has become essential to access data easily. Above all, by so doing the management system and operating process can be standardized (e.g. the use of cost accounting system, performance evaluation, human resource management, and policy announcement etc.). Therefore, it can be made for comparison and also provide useful data for top management when making decisions. This research is conducted with case study in two hospitals with different sizes, missions, and health information systems. It uses the balanced scorecard (BSC) to set key performance indicator (KPI). Each hospital builds data warehouse and data cube for their own KPI. The cube integration operator is used to complete the process of the cube for management center. In addition, problems can be solved by getting those exchange data between different information systems and analyzing chart trend through simple object access protocol (SOAP), On Line Analytical Processing (OLAP) agent layer and office 2000. The results demonstrate that owing to the establishment of this system, the allied hospitals can have their own executive information system (EIS), and the management center can have different platforms and multi-layer EIS. As a result of practice, decision makers can get relevant information quickly through this system and make right strategies. In process of this study, the share of management knowledge for decision makers and system designers is significant. Moreover, users, designers and decision makers of EIS must be sensitive to the change of medical environment to make this system reliable and usable for a long time.

並列關鍵字

BSC ； SOAP ； EIS

參考文獻

J. and Frolick, M. N., “Determining Information Requirements for an EIS,” MIS Quarterly, pp. 255-269, September 1993 【21】 Rochart, J.

文獻參考【01】 Rochart, J. F. and Treacy, M. E., “The CEO Goes On-Line,” Harvard Business Review, 1982 【02】 Turban, E., “Decision Support and Expert Systems: Management Support Systems,” Macmillan Publishing Company, second edition, 1990 【03】 Waston, H. J., Rainer, K. J. and Synder, A., “The Evolution of Executive Information System Software,” Decision Support System, pp. 333-341, 1992 【04】 Millet, I., Mawhinney C. H. and Kallman, E. A., “A Path Framework for Executive Information Systems,” Transactions of The Eleventh International Conference on Decision Support Systems, 1991 【05】 Minear, M. N., ”Implementing an Executive Information System,” INFO/CARD, July 1991 【06】