Exploring the Feasibility of Medical Knowledge Outsourcing ─Using Push and Pull Theory

• Main Authors: Chia-Chen Tsai, 蔡佳臻
• Other Authors: Sho-Fang Chang
• Format: Others
• Language: zh-TW
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/c5d77x

碩士 === 嘉南藥理大學 === 醫務管理系 === 103 === In the knowledge economy age, operational efficiency, flexibility, capacity, and cost down can be enhanced if non-core knowledge work is outsourced. For the past few years, several hospitals have faced financial difficulties, health policy instability, competition pressures and high labor costs. Since hospitals have confronted operational challenges, they have been trying to solve the predicament through medical knowledge outsourcing. However, according to the guidelines of Department of Health (DOH), healthcare settings should establish the review mechanisms to manage and supervise knowledge outsourcing. Therefore, this study, explores the feasibility of medical knowledge outsourcing using push and pull theory. The study used qualitative methods. Four hospital managers and four physicians with outsourcing experience, totally 8 deep interviews were conducted; each lasted 50 to 90 minutes. Grounded theory was used for data analyses. The results showed that lack of manpower, operational difficulties, high workload pressure for teaching, research, and hospital accreditation are push factors of medical knowledge outsourcing. Cost, operational efficiency, holistic care, manpower demand, higher income, lower work pressures and higher degrees of freedom are pull factors. Obstacles factors included legitimacy, cost-effectiveness, quality, accountability, and patient information security issues. These obstacles can be solved by quality management through contracting. Cost, human resources, effectiveness and quality have become the assessment factors of medical knowledge outsourcing. The feasibity of medical knowledge outsourcing is negatively related to the characteristics of medical knowledge including uncertainty, complexity and recessive trait. The highly professionality of medical knowledge is positively related to medical knowledge outsourcing. The scope of knowledge of medical outsourcing includes medical departments, i.e. ER, dialysis and respiratory care, and medical knowledge process, i.e. pathology reports, medical imaging, disease coding. The forms of medical knowledge outsourcing include physician support, medical cooperation, exterior training, cooperative education, industry-university collaboration and laboratory cooperation. This study suggests that hospitals should concern the content and form of medical knowledge outsourcing in the current regulations. Policy-makers may respond to market demand, and consider the deregulation of medical knowledge outsourcing and countermeasures. These issues are worthy of concern by the government, industry and the academy.