The Strategy Map of Developing Health Information：A Case Study of Taiwan

現代資訊科技（Information Technology, IT）的迅速發展，造就了網際網路的環境，引領了人類生活方式的巨大改變，而生活的主要項目之一：求診看病及醫療服務也隨著潮流逐漸增加網際網路的方式，電子病歷也成為各醫院努力推行的重點，衛生署肩負妥善照護國民健康的重責大任，須順應總體環境的變遷，引領我國的公衛體系、醫療界及民眾走向一個高品質、高效率的網路健康照護境界。 為了改善醫療服務體系，以減少醫療疏失、降低成本、提供較好的醫療照顧（better care），世界上已經獲得衛生部會首長甚至最高元首重視且公開宣示，在三至十年內投入大量資金，大力發展國家健康資訊科技 (Health IT)（特別是電子病歷）計畫的國家有美國、加拿大、澳洲、英國、日本、中國等。顯見發展健康資訊已經是不可忽視的潮流趨勢。 衛生署於民國75年6月奉行政院核准成立資訊中心，20年間支用經費近60億元，預算之執行效率及效果不明顯，因而資訊發展之績效並未見大幅提昇。今後醫療資訊發展是否能持續受到政府的重視與支持，關係著全民醫療保健及健康資訊產業之永續發展。 因此，作者乃嘗試以Robert S.Kaplan及David P. Norton的平衡計分卡(Balanced Scoredcard, BSC)及策略地圖（Strategy maps），進行策略規劃（Strategic planning），經由使命（mission）、價值觀（value）、願景（vision）及策略四大構面（財務構面、顧客構面、內部流程面及學習成長面）的建構，並結合平衡計分卡發展策略行動方案，草繪完成「台灣衛生醫療資訊發展策略地圖（The Strategy Map of Developing Health Information of Taiwan）」。 這張策略地圖是首創以策略工具呈現政府(衛生署)全國性衛生醫療資訊發展之策略架構，同時也是首次將衛生署施政藍圖中欠缺的衛生醫療資訊發展的部分詳細呈現，提供全國衛生醫療機構參據，凝聚共識，為未來尋求聚焦及步調一致(Alignment)的發展基礎，以加速推動台灣健康資訊發展。The rapid development of information technology (IT) has created the Internet and brought about huge changes in how people live. One important change is that people are increasingly relying on the Internet to consult a doctor or seek medical services, and hospitals are making every effort to keep electronic medical records. Given its responsibility to promote good health care for the people of Taiwan, the Department of Health (DOH) must adjust to the changing environment and help establish a high quality and effective Internet health care environment that will serve Taiwan's public health system, medical community, and citizens. To improve their health care service systems, reduce the number of medical errors, lower costs, and provide better care, the ministers of health and the heads of state of the United States, Canada, Australia, the UK, Japan, and China have announced projects involving major investments over the next three to ten years to develop health IT (especially electronic medical records). The development of health IT is a trend that cannot be ignored. In June 1986, the DOH established the Health Information Center with the approval of the Executive Yuan. Over two decades, the Health Information Center has spent almost NT$6 billion and has shown no evident effectiveness or results in putting its budget to work. Consequently, health IT has yet to be developed in a significant way. The future development of a health care system for all of Taiwan's people and a health IT industry will depend on whether the government supports or neglects the development of health IT. Therefore, the "Strategy Map of Developing Health Information of Taiwan" has been drawn up to implement strategic planning based on the balanced scorecard (BSC) method and strategy maps developed by Robert S. Kaplan and David P. Norton, as well as the concepts of "mission," "value", "vision" and four strategic perspectives (Financial Perspective, Customer Perspective, Business Process Perspective, and Learning and Growth Perspective). The aim is to implement a strategic action scheme that integrates BSC. The strategy map is a blueprint that incorporates strategic tools and shows the development of national health IT by government agencies (the DOH) and at the same time provides a detailed overview of how the DOH will deal with the shortcomings in implementing a health IT development strategy. It enables health care organizations across Taiwan to verify information and reach a common understanding, and provides a basis for the future alignment and rapid development of Taiwan's health IT system.目 錄 第一章 緒論 1 第一節 研究背景 1 第二節 研究目的 2 第二章 文獻探討 4 第一節 衛生醫療之意義 4 第二節 世界先進或重要國家發展衛生醫療資訊之政策 6 第三節 台灣衛生醫療主管機關之資訊科技發展 14 第四節 我國衛生醫療資訊發展成果 18 第五節 台灣衛生醫療服務業之資訊科技應用 21 第六節 國內醫療資訊現況檢討及ＳＷＯＴ分析 23 第三章 研究架構與方法 30 第一節 策略規劃概述 30 第二節 平衡計分卡概述 33 第三節 建構策略地圖的原則 36 第四節 建構策略地圖 38 第四章 衛生醫療資訊發展策略地圖之建構 42 第一節 導入健康資訊策略地圖的步驟 42 第二節 草繪衛生署資訊發展策略地圖 50 第三節 衛生署各處室策略性議題與策略性目標的形成邏輯 55 第四節 衛生署各處室建構策略地圖之方式 56 第五節 其他衛生機關建構策略地圖之方式 57 第六節 建構策略地圖之預期效益 57 第五章 結論與建議 59 第一節 本研究之限制 59 第二節 本研究之結論 59 第三節 本研究之貢獻 60 第四節 後續研究之建議 61 第五節 平衡計分卡常見問題 61 第六章 參考文獻 65 中文部份 65 英文部份 67 網站部份 6