活動理論為基礎的服務設計研究：以遠距健康照護服務推廣為例

The Research of Service Design Based on Activity Theory: Focusing on the Process of Telehealth care Sevices Promotion

現今病患的求醫行為已不是只在醫院的機構限制裡，過去以醫院為主的專業權威醫療形已開始出現以病人為中心的整合式健康照護，反映出一種求醫行為及醫療保健服務模式的新典範轉變。本研究從社會文化的角度檢視現行遠距健康照護服務的推廣歷程，凸顯出現有服務設計在缺乏考量融入文化脈絡時，服務提供者與病患在互動歷程中所突現的衝突，及其改善契機。本研究應用民族誌，在參與八個月的研究期間內，進行參與觀察與訪談；並以活動理論為基礎，在完成觀察35件的服務推廣活動歷程與26件的訪談中，建構其活動系統與矛盾分析。本研究並依循三大矛盾之脈絡，提出對應文化融入的改善建議，以提供台灣醫療照護產業發展科技化醫療與創新服務設計之方向。

Nowadays, health care seeking behaviors have no longer been restricted their performing in healthcare organizations. This reflects the paradigm shift of health care service delivery model from the perspective of patriarchy on medicine to the patient centered. From the social-cultural perspective, this research aimed on examining the consequences of contradictionaries with the lack of considering cultural embeddeness in the innovative service design process. With the case research focuses on the process of telehealthcare service promotion in a medical center in southern Taiwan, we revealed several insights related to the innovative service design. Based on the Ethnography, we applied activity theory to construct the activity systems of the telehealthcare service promotion from a total of 35 experienced service promotion processes. Furthermore, several contradictionaries were extracted through the activity system in the research. Finally, we provide several suggestions for the future healthcare industry to enhance the understanding of IT-enabled services design with cultural embeddedness.