105年度科學及技術類委託研究計畫「精進健保醫療資訊雲端查詢系統之研究」計畫案

Taiwan National Health Insurance has provided great accessibility for medical service since 1995. However, this convenience also makes patients tend to visit several hospitals and “doctor shopping” has become a relative common phenomenon in Taiwan. Solutions to the duplicated use of medication and medical examination are warranted to reduce the overuse of medical recourses and enhance patients’ safety. Currently, there is no medical informatics system to integrate all medical information among different facilities in Taiwan, to help healthcare professionals treating patients more efficiently. As a result, the Ministry of Health and Welfare developing a health cloud program and encouraging hospitals to upload electronic medical records for sharing. This program will provide a platform for the hospitals, pharmacies, medical labs and rehabilitation clinics to get patients’ complete medical information. Also, National Health Insurance Administration built its Pharma Cloud System in 2013 which required medical institutions to upload the patients’ medication lists. In the near future, all medical institutions in Taiwan will be able to use a new health informatics system, the National Health Insurance Cloud Health System, to review patients’ medical records among different hospitals. The aim of this study included: (1) To understand the implement status of cloud health system in Europe, America and Asia. (2) To understand the necessary medical information for different health professionals to perform their medical interventions. (3) To understand the status and willingness of different health care professionals to use the Cloud Health System in Taiwan, as using the new system, even theoretically can improve the quality of care, but also change the clinical practice. (4) Establish the key performance indicators to evaluate the effectiveness of the Cloud Health System. The present study will combine qualitative and quantitative methods to understand the medical information in cloud system needed for different health care professionals to their practice. Literature review will be conducted first to compare and contrast the current usage of cloud health systems in five highly developed countries in Europe, America and Asia regions. The process of developing the cloud health system, the current status of the system and the relative regulations will all be discussed. A total of six expert focus group meetings will then be held to discuss the necessary medical information for different health care professionals for their practice. Physicians, pharmacists, nurses, physiotherapists, and occupational therapists will be invited to join the focus meetings. The study will also employ the National Health Insurance Cloud Database to evaluate drug-drug interactions among different hospitals, effectiveness of specific medication, duplication of medication, and utilization of expensive examination in medical institutes, including medical centers, regional hospitals and district hospitals. Finally, based on the above findings, a feasible and comprehensive recommendation with key performance indicators will be summarized to NHI for a better decision making in the future.