醫院資訊系統委外策略之研究

近年來隨著國內各醫院資訊系統的逐步建構，醫院資訊系統(HIS)委外策略之研究實屬資訊系統委外的新興重要議題。學者發現，醫院建構較為完善的資訊系統之重要性主要在於資訊系統能大量降低重複性的資料處理流程與成本，大大的降低人為錯誤率並可提昇組織的整合力，降低人事管理的成本並擴及至整體營運成本上，資訊系統儼然已成為醫院最有價值的資源之一，尤其是在健保IC卡制度的全面導入以及政府陸續推行的薄片化、電子病例互通等…的政策下。本研究目的為：一、探討醫院資訊系統委外合作如何進行。二、發展一個醫院資訊系統委外模式。三、探討醫院在不同醫院資訊系統委外方式：整體委外(Total Outsourcing)、自行開發(insourcing)、選擇性委外(Selective Outsourcing)、業務性委外(Business Outsourcing)間如何選擇﹖ 故本研究依據系統複雜性(Shenhar, 2001)及委外程度的高低(Huang et al., 2009 、Lacity and Hirschheim 1993、Lacity and Willcocks 1998)等學者的相關研究理論提出一套全新的醫院資訊系統委外模式，並將委外的類型分為整體委外、選擇性委外、業務性委外與自行開發。本研究擬先以問卷調查受訪醫院資訊系統的建置現況再依據質性深度訪談方式，探討各醫院建置資訊系統的現況及其採行之策略與影響其資訊系統委外程度高低間之相關因素。研究結果顯示：醫院資訊系統的複雜性與醫院規模有相關、醫院資訊系統的複雜性與醫院事業部門種類的多寡有相關、醫院資訊系統委外的程度高低與醫院資訊部門的專業能力有關、公立醫院資訊系統委外的程度高低與醫院等級及政府的政策指導有關、委外可快速取得內部不存在的技術。

關鍵字

醫院資訊系統；整體委外；選擇性委外；業務性委外；自行開發；複雜性；委外程度

並列摘要

Due to the increasing establishment of Hospital Information Systems (HIS) within the nation’s hospitals in recent years, the study of HIS outsourcing strategies has become an important topic for the Information Systems department. Researchers found that hospitals with well-established IS are able to significantly cut down redundant information processing which reduces costs. IS are also able to minimize human errors and increase integration of organizations which reduce the costs of human resources throughout the entire operation. The (HIS) department has become one of the most important resources for hospitals, especially for the Health Care Identification Card system and the continuous governmental promotion of electronic sharing of digitalized medical records and other programs. The purposes of this study are: 1. to investigate how (HIS) works; 2. to develop a (HIS) outsourcing model; and 3. to study how hospitals select among different (HIS) outsourcing models such as Total Outsourcing, Insourcing, Selective Outsourcing, and Business Outsourcing. Therefore, based on theories of (Shenhar, 2001、Huang et al., 2009 、Lacity and Hirschheim 1993、Lacity and Willcocks 1998), this study introduced an all new HIS outsourcing model. It furthermore categorized the outsourcing into Total Outsourcing, Insourcing, Selective Outsourcing, and Business Outsourcing. This study used questionnaires and in-depth interviews to examine each participating hospital’s current information system and the factors that affect the level of outsourcing. The results of this study are as follow. The complexity of the (HIS) is related to the scale of the hospital and the numbers of divisions a hospital has. The level of (HIS) outsourcing is affected by the professional competence of the (HIS) division. Within government hospitals, the level of (HIS) outsourcing is deternmined by the government hierarchy, hospital policies, and instructions. Additionally, outsourcing allow hospitals to gain technologies that are not available internally.