遠距照護的價值評估模式

The Value Evaluation Model of Telecare

洪春安(Chuen-An Hung)

指導教授 ： 許明暉

臺北醫學大學/醫學院/醫學資訊研究所/碩士(2011年)

https://doi.org/10.6831/TMU.2011.00084

摘要

遠距照護(Telecare)服務系統，能提供老年人或慢性病患於熟悉的環境中獲得醫療照護服務，減少往返醫院的頻率，減少醫療負擔，降低健保支出，提昇醫院形象，減少醫療及社會成本。但醫院必須開發系統、建置相關硬軟體資訊設備、生理量測設備，撥出空間，投入醫師、護士、營養師、藥師、資訊人員人力去執行運作，如視訊諮詢、遠距衛教、藥事安全、行動定位、生活資源轉介等服務。如何成功開發遠距照護(Telecare)系統且營運，是醫療機構主管人員很重要課題。對醫療機構而言，在引進遠距照護系統過程中，必須先瞭解是否有引進遠距照護的價值?是否掌握目標客戶需求?需要那些營業伙伴配合?需要提供那些資源?有那些成本?收入來源有那些?因此本研究挑選一般遠距照護的重點業務(1)遠距生理量測(2)視訊諮詢(3)藥事安全服務(4)生活資源轉介(5)警示通報，依據最近年來在瑞士洛桑大學剛獲博士學位，目前經營企管顧問公司的Alexander Osterwalder，其設計的畫布(Canvas)在網路上點閱率極高，依據其企業模式(Business Model)的九個構面與醫護主管及人員在畫布(Canvas)上進行研討，之後再按每一構面作統合整理出結果。
結果:
1.關鍵營業伙伴:社區醫療院所、藥局、生理量測供應商、資訊硬軟體廠商、電信通訊廠商、生活服務資源業者、保全公司。
2.關鍵活動:(1)遠距生理量測 (2)視訊諮詢 (3)藥事安全服務
(4)生活資源轉介 (5)警示通報
3.關鍵資源:
院內資源:
包合醫師、護理師、營養師、藥師等、資訊工程師
。
院外資源:
(1)資訊平台、生理量測儀器廠商等。
(2)生活資源服務公司包括: 行動定位設備公司、醫材輔具租借公司、家事清潔服務公司、餐廳、交通公司等。
(3)社區資源:包合社區病友團體、居家護理機構、鄰里長等。
4.價值主張:
(1)以民眾為中心的整合式照顧服務 (2)提升健康照護服務的可近性。
(3) 應用資通訊科技，建構整合醫療、照護、生活體系模式。提升遠距照護服務品質。
5.顧客關係: 針對下列客戶維持長期信賴配合關係。
(1)糖尿病、高血壓患者(2)輕、中度失能者(3)輕度失智症患者
(4)獨居長者(5)罹患慢性病之主要照顧者(6)經個案管理師評估符合者。

6.配銷通路:現場量測、遠距量測送回、電話關懷指導、經由網路及醫療人員到宅服務。
7.顧客部份:遠距生理量測、視訊諮詢、藥事安全服務、生活資源轉介、警示通報。即時正確就近量測，樂於量測，解決患者疑慮，在服藥及生活上減少不便，減少往返醫院時間及次數，有異常時有醫護人員即時處置協助就醫。

8.成本結構: 醫護人事成本,醫院及社區站硬體軟體成本,行政費用,量測成本。
(1)人事費: 專業諮詢醫療團隊、主管、個案管理師、資訊、行政人員等。
(2)設備成本:固定成本含辦公設備、裝潢費用、資訊設備軟體、資訊硬體設備。
(3)其他經營成本:辦公費用、行銷、廣宣、設備折舊。
9.收入:會員費、藥品費、藥品運送費、安全服務費、生活資源轉介服務費、交通費。

關鍵字

遠距照護 ； 企業模式 ； 畫布

並列摘要

Telecare system provide the elderly and chronic patients in a familiar environment to obtain medical care, reduce the frequency to hospitals and reduce the medical burden, lower health care spending, improve the image of hospitals, reduce social costs. However, the telecare system must be developed, building hardware and software related to information technology equipment, physiological measurement equipment, allocation of space, many IT persons, doctors, nurses, dietitians, pharmacists, to carry out development and operations, such as video consultation, tele-health education, pharmaceutical safety, mobile positioning, living resources and referral services,. Medical institutions, in the process of introducing telecare system, One must see whether the value of the introduction of Telecare? Who is the goal customer? What resources? What is the cost structure? Where are the revenues? Therefore, I select 5 general business of Telecare (1) Long distance measurement (2) Video Consulting (3) Pharmaceutical Security Services (4) living resources transfer (5) Alert notification Services, According to the business model of Alexander Osterwalder to discuss with some professional person. Alexander Osterwalder who has just received his Ph.D from the University of Lausanne in Switzerland, and have MBA Management Consultant company, his design canvas have very high click rate on the network. After discuss we summary the report according the nine dimensions of model. I hope the results is helpful for the medical care institute that want to setup Telecare system.
Results:
1. The key partners: the hospital, pharmacy, physical measurement providers, IT hardware and software vendors, telecommunications companies, life service resources industry, security companies.
2. Key activities: (1) physical distance measurement (2) Video Consulting (3) Security Services Pharmaceutical(4) living resources referral (5) warning notification
3. The key resources:
Inside hospital resources:
Inclusion physicians, nurses, nutritionists, pharmacists, IT Engineer
Outside hospital resources:
(1) information platform, equipment manufacturers and other physiological measurements.
(2) living resources services company, including: mobile positioning device companies, medical supplies and assistive devices leasing company, the family cleaning service companies, restaurants, transportation companies.
(3) community resources: community patient organizations, home care agencies, neighborhood leader.
4. Value Proposition:
(1) people-centered integrated care services (2) improve health care services accessibility.
(3) Use information and communication technology to construct an integrated medical care, life system model. Improve the quality of telecare services.
5. Customer relations: maintain a long-term trust relationships with the following customers.
(1) diabetes, hypertension (2) disabilities (3) patients with mild dementia(4) the elderly people who living alone (5) primary caregivers of chronic diseases (6) assessment by the case manager are consistent.
6. Distribution channels: on-site measurement, distance measurement back, telephone care for guidance, and medical personnel via the Internet to their home.
7. Customer needs: physiological measurement of long distance, video consulting, security services, pharmaceutical, life resources, referrals, notification alerts. Near real-time measurement of the right, willing to measure to address the concerns of patients in the medication and reduce the inconvenience to their daily lives, reducing the time and frequency from the hospital, there are exceptions when immediate disposal of medical assistance for medical treatment.
8. Cost structure: the cost of health care personnel, hospitals and the community Station software, hardware costs, administrative costs, measurement costs.
(1) Personnel costs: professional consulting medical team, supervisor, case manager, IT and administrative personnel.
(2) Equipment cost: fixed costs, including office equipment, decoration costs, IT equipment, software, IT hardware.
(3) Other operating costs: office expenses, marketing, wide publicity, equipment depreciation.
9. Income: membership fees, drug fees, drug delivery fees, security fees, living resources
trnasfer services, transportation.

並列關鍵字

Telecare ； Value proposition ； Canvas

參考文獻

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