Responsive image
博碩士論文 etd-0127110-141525 詳細資訊
Title page for etd-0127110-141525
論文名稱
Title
居家健康管理模式之創新與核心能力分析
Analysis of Home Health Management Innovation and Core Capabilities
系所名稱
Department
畢業學年期
Year, semester
語文別
Language
學位類別
Degree
頁數
Number of pages
154
研究生
Author
指導教授
Advisor
召集委員
Convenor
口試委員
Advisory Committee
口試日期
Date of Exam
2010-01-14
繳交日期
Date of Submission
2010-01-27
關鍵字
Keywords
科技、核心能力、創新、健康照護
Technology, Core capability, Innovation, Home health
統計
Statistics
本論文已被瀏覽 5760 次,被下載 0
The thesis/dissertation has been browsed 5760 times, has been downloaded 0 times.
中文摘要
二十一世紀資訊科技與通訊技術的快速發展,也間接影響到了醫療健康產業,醫療健康產業導入電子化的趨勢也因應而生。本研究採用次級資料分析法,從大量資料中分析、整理歸納出居家健康服務的內容和模式,討論資訊科技導入所產生的影響及可提供之創新和變革,並透過專家深度訪談作為評估標準,進而探討面對創新與變革,居家健康服務的利益關係人:居家面、照護面、IT面可能產生的衝擊應具備的核心能力,以回應創新所造成的能力落差。
研究結果指出從居家健康管理模式的創新,對於居家面和照護面其科技知識及服務模式都會面臨創新及衝擊,本研究提出五大健康管理情境需求探究可能產生的科技和服務變革,基於上述的分析基礎,最後歸納出健康管理模式中利益關係人採用創新服務的核心能力,並提出因應變革的策略性建議,以提供醫療健康產業洞察及擴展健康管理服務商機之依據,彌補變革所造成的知識落差,以協助其有效管理新一波的健康服務模式轉變之衝擊。
Abstract
In the 21st century, the rapid developments and growth of information and communication technology have triggered a new wave of Healthcare Industry. This study utilizes the secondary data analysis to analyze and generalize the processes, contents and models of health care management. In addition, discuss the changes in both healthcare informatics and medical related processes based on the innovations for the traditional models to the new home health care management models. Further, the standard of the evaluation are according to the expert consultations, to see the critical impacts of the innovations on the stakeholders: healthcare customers, healthcare providers and healthcare regulators are identified, so as to explore the core capabilities in these dimensions of the innovation.
These results indicate that the innovations for home health management care are differences in the technological knowledge and business model aspects. We further identify five home health management models and their core business capabilities that are necessary for the stakeholders to cope with the changes, each appearing to address either technical or care aspects of the transformation. The findings have the potential to contribute to the understanding of impacts occurring in the change associated with the innovation in the care process and offer rich insights for the stakeholders to exploit the opportunities.

目次 Table of Contents
致謝詞-------------------------------------------------------------Ⅰ
摘要---------------------------------------------------------------Ⅱ
Abstract-----------------------------------------------------------Ⅲ
第壹章 緒論------------------------------------------------------ 1
第一節 研究背景與動機---------------------------------------- 1
第二節 研究目的與範圍---------------------------------------- 5
第貳章 文獻探討-------------------------------------------------- 6
第一節 居家健康管理之模式分析-------------------------------- 6
一、產業定義------------------------------------------------ 6
二、需求對象及情境------------------------------------------ 8
三、流程改善重點-------------------------------------------- 9
第二節 居家健康管理之科技應用-------------------------------- 12
一、e-health定義與產業現況--------------------------------- 12
二、科技應用:【DDS and PIC server】------------------------- 15
三、科技應用:【Vital Sign】--------------------------------- 16
四、科技應用:【睡眠品質、環境參數、活動力 監測系統 】------- 17
五、科技應用:【RFID-智慧型醫藥箱、外出行為監測】------------ 20
六、科技應用:【Magic Mirror & GPS隨身定位機 & PDA】--------- 22
第三節 居家健康管理之品質衡量-------------------------------- 24
一、品質衡量的定義------------------------------------------ 24
二、評估工具------------------------------------------------ 28
第参章 研究方法-------------------------------------------------- 30
第一節 次級資料分析法之描述---------------------------------- 30
第二節  次級資料分析法之研究步驟與流程------------------------ 33
第肆章 居家健康管理模式之創新------------------------------------ 37
第一節  創新模式---------------------------------------------- 37
一、生理值紀錄與量測-【Vital Sign】------------------------- 38
二、觀察臨床表徵-【活動力參數監測 & 睡眠品質監測】---------- 41
三、執行醫囑-【智慧型醫藥箱 & Magic Mirror】---------------- 43
四、居家安全監控-【RFID & GPS隨身定位機 & 環境參數監測】---- 45
五、健康訪視諮詢-【PDA & DDS and PIC server】--------------- 47
第二節 可用性分析-------------------------------------------- 49
一、 創新模式評估-------------------------------------------- 49
二、 專家訪談評估-------------------------------------------- 53
第伍章 核心能力分析---------------------------------------------- 62
第一節 居家健康管理模式之變革-------------------------------- 62
第二節 創新模式利益關係人------------------------------------ 67
第陸章 討論與結論------------------------------------------------ 75
第一節 研究結果---------------------------------------------- 75
第二節  研究貢獻---------------------------------------------- 81
第三節  研究限制與未來發展------------------------------------ 83
參考文獻---------------------------------------------------------- 86
附錄-------------------------------------------------------------- 92
附件一:專家深度訪談問卷------------------------------------------ 92
附件二:專家深度訪談逐字稿--------------------------------------- 110

圖目錄
圖1.1 世界人口結構發展趨勢------------------------------------- 1
圖1.2 我國人口結構發展現況與趨勢------------------------------- 2
圖2.1 Disease Management, Living independent健康管理需求組織圖- 8
圖2.2 Healthy Family 健康管理需求組織圖----------------------- 8
圖2.3 居家健康管理流程圖-------------------------------------- 11
圖2.4 居家健康照護模式基本架構-------------------------------- 12
圖2.5 居家健康照護模式IT應用示意圖---------------------------- 13
圖2.6 DDS and PIC Server應用示意圖應用示意圖------------------- 15
圖2.7 Vital Sign應用示意圖------------------------------------ 17
圖2.8 睡眠品質監控應用示意圖----------------------------------- 18
圖2.9 環境參數監測範圍與內容----------------------------------- 19
圖2.10 活動力監測之範圍與方式----------------------------------- 20
圖2.11 RFID外出行為監測(左);智慧型藥櫃(右)-------------------- 21
圖2.12 Magic Mirror--------------------------------------------- 22
圖2.13 GPS隨身定位機-------------------------------------------- 23
圖2.14 品質的三種切入面----------------------------------------- 25
圖2.15 個案管理主要層面之交互活動------------------------------- 27
圖2.16 居家照護之品質衡量指標----------------------------------- 28
圖3.1 次級資料分析法之研究方法--------------------------------- 33
圖3.2 研究流程------------------------------------------------- 36
圖4.1 居家健康管理模式之創新模式流程圖------------------------- 37
圖4.2 利用Vital Sign 之生理值紀錄與量測創新模式---------------- 39
圖4.3 利用活動力參數監測&睡眠品質監測之觀察臨床表徵創新模式---- 43
圖4.4 服藥提醒情境示意圖--------------------------------------- 44
圖4.5 利用智慧型醫藥箱 & Magic Mirror之執行醫囑創新模式-------- 45
圖4.6 外出行為紀錄示意圖--------------------------------------- 45
圖4.7 利用RFID&GPS隨身定位機&環境參數監測居家安全監控創新模式-- 46
圖4.8 利用PDA & DDS and PIC server之健康訪視諮詢創新模式------- 48
圖4.9 居家健康照護模式之創新-以預防二次中風患者為例------------ 50
圖5.1 創新居家健康照護模式之利益關係人------------------------- 67
圖6.1 居家健康管理創新模式之應用環境示意圖--------------------- 75

表目錄
表2.1 居家健康管理評估指標------------------------------------- 28
表4.1 居家健康管理創新於照護面可節省之時間--------------------- 49
表4.2 居家健康管理創新於居家面可節省之時間--------------------- 50
表4.3 居家健康管理模式創新應用於預防二次中風之預期效益--------- 51
表4.4 居家健康管理創新於其他品質指標之改變--------------------- 51
表4.5 居家健康管理創新之創新服務------------------------------- 51
表4.6 專家訪談名單--------------------------------------------- 54
表5.1 居家健康管理對於服務接受端與提供者的改變----------------- 63
表5.2 醫療服務經營模式的改變----------------------------------- 64
表5.3 照護面之核心能力----------------------------------------- 70
表5.4 居家面之核心能力----------------------------------------- 72
表5.4 IT面之核心能力------------------------------------------- 74
表6.1 居家健康照護模式創新結果整理----------------------------- 76
參考文獻 References
一、中文部份
賈淑麗,「台灣居家護理現況分析」,社區發展季刊,92,2002,55-65。
陳世堅,「從社政到衛政長期照顧連續性光普系統模式研擬」,當代社會工作學刊,4期,2004,1-55。
藍忠孚等,醫療品質管理學,華杏出版股份有限公司,2001。
盧瑞芬、謝啟瑞,醫療經濟學,學富文化事業有限公司,2000。
吳仁和、林信惠,系統分析與設計-理論與實務應用,智勝,台北,2004年2月
賈淑麗、陳重榮,居家照護,五南,台北市,2000。
二、英文部分
Afuah, A. and Barhram, N., “The Hypercube of Innovation”, Research Policy, Vol.24, No. 1, 1995, 51-76.
Afuah, A. and Tucci, L., Internet Business Models and Strategies: Text and Cases 2nd edition, Boston, McGraw-Hill, 2003.
Booch, G., Rumbaugh, J. and Jacobson, I., The Unified Modeling Language User Guide, Addison Wesly, Reading, MA, 1999.
Chumbler, N.R., Mann, W.C., Wu, S., Schmid, A. and Kobb, R., “The association of home-telehealth use and care coordination with improvement of functional and cognitive functioning in Frail elderly men”, Telemed J E Health, Vol. 10, NO. 2, 2004, 129-137.
Cookfair, J.M. and Markel, S.K., “Care of clients in the home,” Nursing Care In the Home, Vol. 37, No. 4, 2004, 511-517.
Cooper, R. and Schindler, S., Marketing Research, New York: McGraw-Hill, 2006.
Courtney, K.L., Pack, B. and Porter, G., “Within their grasp-hand-held computer use among registered nurses,” Business Briefings: US Healthcare Strategies, 2005, 14-15.
Dansky, K.H. and Ajello, J., “Marketing telehealth to align with strategy”, J Health Manag, Vol. 50, No. 1, 2005, 19-30.
Dyer, K.A., “Ethical challenges of medicine and health on the Internet:a review”, Journal of Medical Internet Research, Vol.3, No.2, 2001, 23.
Englebardt, S.P. and Nelson, R., “Health Care Informatics: An interdisciplinary approach,” Missouri: Mosby, 2002.
Englebardt, S.P. and Nelson, R., ”Health Care Informatics: An interdisciplinary approach”, Missouri:Mosby, 2002.
Eysenbach, G., “What is e-health,” Journal of Medical Internet Research, Vol. 3, No. 2, 2001, 20.
Eysenbach, G., “What is e-health?”, Journal of Medical Internet Research, Vol.3, No. 2, 2001, 20.
Hebert, MA and Korabek, B., “Stakeholder readiness for telehomecare: implications for implementation,” Telemed J E Health, Spring Vol.10, No.1, 2004, 85-92
Kuroda, A., Tanaka, K., Kobayashi, R. and Nakamura, K., ”Effect of care manager support on health-related quality of life of caregivers of impaired elderly: one-year longitudinal study”, Ind Health, Vol. 45, No. 3, 2007, 404-408.
LaPlante, MP, Harrington, C. and Kang, T., “Estimating paid and unpaid hours of personal assistance services in activities of daily living provided to adults living at home”, Health Serv Res, Vol. 37, NO. 2, 397-415.
Leslie, C. and Patricia, W., “Telehealth: An integrated clinical information system solution,” Supplement to the Remington Report, 2003, 11-13.
Mc, E.M., Home health care nursing, 1st Edition, community-based nursing, Philadelphia, W.B. Saunders Company, 2001.
Meystre, S., “The current state of telemonitoring: a comment on the literature”, Telemed J E Health, Vol. 11, No. 1, 2005, 63-39.
Mihail, C., “User Acceptance of wireless text messaging in telehealth: a case for adherence,” McMaster University, 2007
Payne, S.M., Digiuseppe, D.L. and Tilahun, N., “The relationship of post-acute home care use to Medicaid utilization and expenditures,” Health Services Research, Vol. 37, No. 3, 2002, 683-710.
Porell, F.W. and Miltiades, H.B., “Regional differences in functional status among the aged”, Soc Sci Med, Vol. 54, NO. 8, 2002, 1181-1198.
Sabine, K., “Home telehealth-Current state and future trends,” International Journal of Medical Informatics, No. 75, 2006, 565-576.
Solberg, L.I., Lyles, C.A., Shore, A.D., Lemke, K.W. and Weiner, J.P., “Is quality free? The relationship between cost and quality across 18 provider group,” Am J Manag Care, Vol. 8, No. 5, 2002, 413-422.
Strawderman L and Koubek R, “Quality and usability: in a health clinic”, Int J Health Care Qual Assur Inc Leadersh Health Serv, Vol. 19, No. 2-3, 225-236.
Turvey, C.L., Willyard, D., Hickman, D.H., Klein, D.M. and Kukoyi, O., "Telehealth screen for depression in a chronic illness care management program.", Telemed J E Health, Vol12, No.1, 2007, 51-56.
Tushman, L. and Anderson, P., “Technological Discontinuities and Organizational Environment,” Administrative Science Quarterly, Vol. 31, NO. 3, 2001, 439-465.
Wootton, R., Jebamani, L.S. and Dow, S.A., “E-health and the University 21 organization: 2. Telemedicine and underserved populations,” Journal of telemedincine and telecare, Vol. 11, No. 5, 2005, 221-224.
Wu, J.H. and Hsia, T.L., “Analysis of E-commerce Innovation and Impact: A Hypercube Model,” Electronic Commerce Research and Applications, Vol. 3, NO. 4, 2004, 389-404.
Young, G.J., Burgess, J.E. and Valley, D., “Competition among hospitals for HMO business: effect of price and nonprice attributes,” Health Serv Res, Vol.27, NO. 5, 2002, 1267-89.
三、網站部份
行政院主計處,http://www.dgbas.gov.tw/mp.asp?mp=1
行政院衛生署統計資料,http://www.doh.gov.tw
行政院經濟建設委員會,http://www.cepd.gov.tw/
內政部:臺閩地區老人狀況調,http://www.moi.gov.tw/stat/Survey/old89.htm
中央健康保險局,http://www.nhi.gov.tw/
經濟部智慧財產局,http://www.tipo.gov.tw/ch/

電子全文 Fulltext
本電子全文僅授權使用者為學術研究之目的,進行個人非營利性質之檢索、閱讀、列印。請遵守中華民國著作權法之相關規定,切勿任意重製、散佈、改作、轉貼、播送,以免觸法。
論文使用權限 Thesis access permission:校內校外均不公開 not available
開放時間 Available:
校內 Campus:永不公開 not available
校外 Off-campus:永不公開 not available

您的 IP(校外) 位址是 54.163.195.125
論文開放下載的時間是 校外不公開

Your IP address is 54.163.195.125
This thesis will be available to you on Indicate off-campus access is not available.

紙本論文 Printed copies
紙本論文的公開資訊在102學年度以後相對較為完整。如果需要查詢101學年度以前的紙本論文公開資訊,請聯繫圖資處紙本論文服務櫃台。如有不便之處敬請見諒。
開放時間 available 已公開 available

QR Code