應用德菲法與層級分析法建構基層醫療機構醫療資訊系統外包商評選模式

Developing a Model for Selecting Medical Information System Outsourcing Vendors Using Delphi and AHP

許碧芳(Pi-Fang Hsu) ； 許美菁(Mei-Ghing Hsu)

《醫務管理期刊》 7卷1期 (2006/03) Pp. 40-56

https://doi.org/10.6174/JHM2006.7(1).40

摘要

民國84年全民健保開辦以來，醫療費用申報的方式逐步改以電子媒體申報，醫療機構不得不加速電腦化的腳步，許多診所的資訊系統委外除了能專注於核心事務外，還可節省日後醫療系統的開發與維護的成本、人事費用、協助醫療費用的申報以及提高人員工作效率，於民國90年西醫基層醫療總額支付制度的實施，迫使醫療費用點值為浮動制，許多地區診所紛紛面臨倒閉的危機，加上健保IC卡的上線，醫療資訊成本的投入卻越來越多，診所的經營越來越困難，對於健保環境的特殊性與醫療的專業性，使得醫療機構在資訊系統委外選商的考量上，添增了評估選擇的複雜度與抉擇的挑戰性，本文運用開業醫師專家的群體決策以德菲法技術選定適用於基層醫療機構在資訊系統委外選商的一系列關鍵評估準則，並且利用層級分析法(Analysis Hierarchy Process; AHP)建立一套醫療資訊系統(Medical information system; MIS)外包商的評選模式，期望本模式能提供台灣基層醫療機構，一套客觀、有效的方式來選擇最適的MIS廠商。

關鍵字

醫療資訊系統 ； 委外 ； 德菲法 ； 層級分析法

並列摘要

Since the National Health Insurance scheme was established in 1995, medical expenditures have been recorded via electronic media as the Taiwanese government promotes the use of the National Health Information Network (HIN), enabling medical institutions island wide to make data accessible and transparent in a digital form. The information system outsourcing attempts to simplify an enterprise's functions, thus enabling the enterprise to concentrate its core business, increase flexibility to compete with an external environmental change and save costs or cope with information technology personnel shortages. Since the implementation of Global Budget measures in the National Health Service (NHS) payments of in 2001. Additionally, introduction of an online National Health IC card requires considerable investment in medical information resources, thus posing a significant challenge for hospital administrators. However, the inability of clinics to adopt an explicit and objective standard to select information technology suppliers may lead to an inappropriate selection, subsequently increasing development and maintenance-related costs, a waste in human resources and time, inefficiency in the processing of medical expenditures, as well as the inability to promote the quality of medical treatment. Criteria for outsourcing vendors and sub-criteria of medical information system for clinics are then evaluated using the Delphi method. Moreover, results of interviews with experts are integrated with the AHP method to establish an objective evaluation criterion for MIS vendors. The proposed AHP model can assist the primary practitioner in similar multi-criteria tasks in an objective and systematic manner when selecting appropriate information software firms.

並列關鍵字

Medical Information System ； Outsourcing ； Delphi Technique ； Analytic Hierarchy Process

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