以病歷為基礎的醫務知識化管理導入架構建立研究

A Research on Medical Records-based Knowledge Management Structure apply to Clinical Managements

陳炳堯(Ping-Yau Chen)

指導教授 ： 顧志遠

中原大學/商學院/企業管理研究所/碩士(2002年)

https://doi.org/10.6840/cycu200200528

摘要

摘 要

在「知識經濟時代」裡，企業的智慧與專業創造了絕大部分的競爭優勢，其生產力的來源不再依賴硬體資源，是以知識為基礎的知識化策略，而醫療產業是一個資本密集、人力密集、而且知識密集的健康事業，因此醫療業的知識管理活動逐漸為醫務管理者所重視。
　　醫療知識的轉移靠醫療人員傳遞，而在醫療院所中，除了醫療人員外，知識集中於病歷記錄中，因此欲進行醫療知識管理就必須針對病歷建立一套完善的管理制度。本研究選擇病歷作為醫療知識的傳播工具，乃是有感於現階段泛知識化現象，企圖利用實體病歷的管理活動，建立醫療知識管理的可行架構。
　　為此，本研究結合知識管理學術理論與病歷管理的實務操作，推論導入醫療知識管理的架構為1、創新病歷管理的定義；2、建立醫療知識的載體；3、病歷的累積與儲存；4、病歷的流通與加值。醫療知識是醫院的核心競爭力所在，透過醫療知識管理活動，提昇經營績效與促進醫學研究發展是建立民眾終身健康照護網路的重要活動。
在個案實證中，本研究以資訊的密度及資訊獲得的難易度為主要考量因素，同時以『標準化程度』及『資訊建設投入程度』為構面將國內各醫療院所區分為四個類型﹔分別是『知識啟動型』、『知識建置型』、『知識停頓型』及『知識變革型』，並歸納各類型醫院導入知識管理的適切性，其中『知識建置型』醫院資訊密度最高、最適合實施知識管理活動，本研究選定某醫療體系作為個案醫院，以所建立的知識管理導入架構來說明其知識加值活動，藉以印證本研究所建立的知識管理導入架構之可行性。

關鍵字

知識管理 ； 知識載體 ； 病 歷管理

並列摘要

Abstract
In an era when the development of economy is based on knowledge, competitive edges lie mostly in wisdom and professionalism of an enterprise. Hardware assets are no longer interpreted as the primary sources for productivity. Instead, knowledge-based strategy is the key driver for a successful business. So is healthcare industry. A successful healthcare industry intensively integrates capitals, human resources and knowledge. As the trend goes, knowledge management of the healthcare industry has progressively received the best attention as well.
The distribution and dissemination of healthcare knowledge rely on healthcare personnel. Besides the personnel at healthcare institutions and clinics, the knowledge also rests in the patients' medical records. To launch healthcare knowledge management, a system that best manages the medical records has to be adopted first. In view of the phenomena of generalized knowledge, this study pinpoints the patient's medical records as a practical and valuable tool to disseminate healthcare knowledge, aiming to establish a viable structure that manages healthcare knowledge.
　The study integrates the theory of knowledge management and the practice of managing the patient's medical records. It concludes four phase-in structures that would lead to healthcare knowledge management:
1. to innovate the definition of patients' medical records management.
2. to build up the driver for healthcare knowledge.
3. accumulation and storage of patients' medical records.
4. the distribution and value-adding of patients' medical records.
Healthcare knowledge is the core competence for a medical institution/clinic to thrive on. By way of promoting healthcare knowledge management activities/campaigns, the operational performance of a medical institution/clinic will rise and shine. Medical R&D will further be facilitated as well. All this contributes to a lifelong healthcare networking for the public.
Among the cases studied, the information flow density and accessibility are factored into with most weighting. In the meantime, based on the "level of standardization" and the "level of information infrastructure involvement", medical institutions/clinics island-wide are classified into four types: knowledge initiator , knowledge builder, knowledge retardant and knowledge reformer. The study also tries to find out the propriety and feasibility if knowledge management is respectively introduced to the four types of medical institutions/clinics. Ultimately, it is interesting to find that the medical institutions as "knowledge builder" suit best to launch knowledge management activities with their high density of information flow. This study chooses a medical group as our study subject. Employing the self-established knowledge management phase-in structure, this study makes an effort to elaborate on the group's knowledge value-adding campaigns in a bid to justify the viability and feasibility of the knowledge management phase-in structure this study is trying to establish.

並列關鍵字

Medical Records Management ； Knowledge Management ； Knowledge Carrier

參考文獻

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