運用地圖化個案管理系統於社區醫院居家訪視之研究

Combining Maps and a Case Management System to Support Home Visits by Community Hospitals

目的：因新北市某社區醫院為了促進民眾健康並瞭解民情而提出社區居家訪視計劃，初期以人工作業方式進行資料整理較耗費時間，於是開發者設計結合Google Maps 功能的「社區居家訪視回饋系統」協助進行數據管理。方法：本系統以PHP 與MySQL 為基礎進行設計，並對曾參與訪視的同仁共110 位進行問卷調查瞭解系統所需改善之處，回收份數為101 份。結果：資料庫採用醫院於2012 年3 月至2014 年12 月社區民眾訪視資料共1,647人並於地圖上呈現個案分布，以Haversine 公式計算受訪個案離醫院居住平均距離為1.47 公里，臨床系統應用者（N=26）在系統改善問卷中建議應提供手機平板介面者為最多（53.8%）。結論：運用Google Maps 在呈現個案居住整體性上較為清楚，問卷調查結果亦顯示系統仍應具行動化的優勢，才能讓訪視者感到實用。

Objective: Our community hospital in New Taipei City participates in a capitation plan. In order to promote public health and to address unmet needs, we proposed several plans involving home visits within the institute’s responsible area of care. To facilitate data collection and to decrease time spent in staff processing, we combined the function of Google Maps with features of an instantaneous feedback system to support home visits. Methods: The system was designed based on PHP, MySQL. After a community-based case visit was completed, our system could mark each case with an icon according to their residential address on Google Maps. In order to understand the weaknesses and strengths of this system, a feedback questionnaire survey was sent to 110 relevant medical staff. A total of 101 questionnaire responses were returned. Results: A total of 1,647 cases with related geographic data were collected between March 2012 and December 2014. All the collected data were displayed in graphic format. The Haversine formula calculated the average distance between case residence and hospital to be 1.47km. Clinical users (N=26) also provided feedback about mprovements in this system and noted that a mobile interface would be preferred (53.8%). Conclusions: This proposed system, combined with Google Maps, significantly improved the data presentation. According to the feedback, clinical users suggested that this system should provide a mobile interface to improve the users’ experience.