IC金融卡與健保卡合一使用：台大醫院之經驗

Combination of Health Insurance Card and IC Card: National Taiwan University Hospital Experience

「健保IC金融卡」乃是結合健保卡和IC金融卡的功能，一方面當作健保就醫憑證，另一方面保留原IC金融卡圈存、消費轉帳，一卡兩用。政府藉金融機構全力開發IC金融卡市場的時機，加速推動實施「一卡到底」政策，以期能便利民眾就診、減少換卡作業。因此乃由行政院衛生署及中尺健康保險局委託台大醫院規劃「一卡到底」計畫。台大醫院健保IC金融卡實驗系統包括以下的功能：（一）取代目前之健保卡，（二）不必換卡，即可更新就醫記錄，（三）健保IC金融卡因附有照片可作為驗證身份之用，（四）結合醫院收費電腦管理系統，自動扣繳醫療費用以及自動轉帳作業。台大醫院除了提供以上功能之外，更利用IC卡的特性開發健保IC金融卡自助服務系統，方便民眾自己更新健保IC金融卡、門診掛號、查詢和預約等服務措施。本計劃實驗成果指出本院員工持卡率為93.5%，有33%以上員工使用過健保IC金融卡就醫看病，使用健保IC金融卡就醫者每月約占員工總就診數的18%，87%使用過健保IC金融卡看病者認為方便，另外，10.7%認為不方便，其原因依次為：（1）健保IC金融卡目前不普遍侷限了可以去就醫的醫療院所；（2）對健保IC金融卡知識了解不足；（3）怕麻煩，怕扣錯款，不想用或嫌圈存手續麻煩等。本文建議將來推廣健保IC金融卡的策略應優先考慮其取代健保卡的功能，其次考慮健保IC卡非一定要具備金融卡的功能。

Application of smart cards in health care is a global trend. Smart cards preserve the function of credit cards and also serve as identification cards for health plans. The government of Taiwan is developing a smart card that can share resources with the health system. National Taiwan University Hospital was assigned to study the use of smart cards in health care. The smart card used in this project was designed to 1) replace health insurance cards. 2) allow for medical registration. 3) serve as a photo identification card. 4) allow direct health care billing. NTUH also installed a self-service machine in the outpatient department, with which cardholders can register for or check appointments and renew their smart cards. The results of this study showed that 93.5% of NTUH employees held smart cards but only 33% had used them for medical registration. Monthly, about 18% of employees who sought medical treatment at NTUH used the smart card for registration. Results of a questionnaire survey of those who had used of the smart card showed that 87% felt it to be convenient, while 10.7% felt it was inconvenient. The most commonly cited drawbacks mentioned by the respondents were 1) the card could be used for registration only at NTUH; 2) poor understanding of the card; and 3) concern about money being incorrectly deduct from accounts; and 4) the card was 'troublesome'. According to these study results, we suggest that the smart card should have more functions in the field of health insurance plans and that removing the credit card function of the card might be considered.