居家醫療資訊科技服務平台之需求探討

Exploring the requirements of home medical carers and carees for a technological information platform

目標：本研究旨在了解居家醫療服務過程之主要參與者對於資訊科技平台的需求，以作為國家相關單位及長照產業之參考。方法：本研究以居家醫療服務的主要參與者為研究對象，包含三類型：（1）醫師、（2）護理師，及（3）長照服務的使用者與潛在使用者，採立意抽樣方式取得研究樣本，運用焦點團體訪談進行資料收集。後續，使用內容分析法（content analysis）進行資料分析，將訪問內容進行主題編碼歸類，進而了解臨床人員及民眾對於居家醫療資訊科技服務平台的需求及期待。結果：臨床人員及民眾對於居家醫療資訊科技服務平台的需求大致可歸納為四大主題，分別為：（1）提升行政效率、（2）照護連續性、（3）長期照護服務諮詢與整合、及（4）照護品質。醫護端期望透過科技平台使作業流程更為精簡順暢，以協助行政效率有所提昇，並希冀科技平台可輔助進行資訊交換共享，以掌握個案的生理資訊，進而增進照護連續性及照護品質；長照服務的使用者與潛在使用者則期望透過平台追蹤專業照顧人員的服務狀況並與其進行即時互動，同時亦希望平台協助進行相關評估且將服務進行整合，並透過單一窗口獲得高品質的服務。然而，目前應用於我國居家醫療服務過程的相關資訊系統，因具有（1）照護資訊分散於各資訊系統；（2）行政管理作業支援功能不夠全面；（3）無法及時提供照護資源的相關資訊；（4）無法達成雙向交流等不足之處，故無法滿足上述需求。結論：雖然台灣政府已有開發居家醫療服務的相關資訊平台，以促進居家醫療服務的發展，然這些資訊系統皆無法完全滿足使用者的需求。因此如何發展具備（1）提升行政效率、（2）增進照護連續性、（3）協助長期照護服務諮詢與整合、及（4）促進照護品質等功能的整合資訊平台將會是我國為未來相關單位應優先考量的面向。 Objectives: The purpose of this study was to explore the requirements of home medical carers and carees for a technological information platform. Methods: This was a qualitative study. The research participants, recruited through purposive sampling, were individuals with experience of home medical services, including doctors, nurses, and users and potential users of long-term care services. Content analysis was used to analyze the text. Results: Four themes emerged regarding the requirements that a technological information platform should meet: (1) high administration efficiency; (2) promotion of continuity of care; (3) integration of long-term care services and service consultation; and (4) promotion of quality of care. The doctors and nurses who administered home medical care stated that the platform should promote continuity and quality of care by improving work efficiency and simplifying communication between health care professionals and caregivers (or care recipients). The users and potential users of home care services hoped that they could obtain information about their service status and communicate with health care professionals. In addition, the users and potential users expected that the platform could integrate long-term care services and provide related health and welfare information; moreover, they wished to have access to high quality services through one single platform. Based on our review, the current information technology system of home medical care in Taiwan faces the following four challenges in meeting users' needs: (1) care information is held in various information systems; (2) the administrative support functions are not sufficiently comprehensive; (3) information on care resources is not provided in a timely manner; and (4) communication is monodirectional, from carers to carees. Conclusions: Although the Taiwanese government has developed several platforms to facilitate the development of home medical care services, these platforms do not meet users' needs. In an integrated information platform, the following functions must be prioritized: (1) high administrative efficiency; (2) promotion of continuity of care; (3) integration of long-term care services with service consultations; and (4) promotion of quality of care.