論文摘要

醫院資訊系統策略調準對績效影響之研究

黃英祥

自從民國八十四年起，台灣政府實施全民健康保險計畫，對全民提供了廣泛的，一致性的健康照護服務。而自從實施全民健康保險計畫以來，可以確信的是健康照護產業市場的激烈競爭現象呈現白熱化。醫院為了存活下來，就必須提昇醫院經營的效率並且提供病患高品質的醫療服務。在這種情形之下，醫院通常會透過採用合適的策略，來因應外部環境的改變。因此，醫院採用經營策略與內部資源形成策略調準的模式有漸增的趨勢。

醫院管理者認知資訊系統是最有價值的資源，因此促進了醫院管理者將資訊系統納入嚴謹的管理活動中。而為了運用管理資訊系統，來達成較好的醫院經營績效。管理策略專家建議醫院，將資訊系統與醫院的經營活動相結合。如同應用在其他的資源一樣，例如人力資源，將資訊系統當做資源時，資訊系統可以透過調準的模式(稱之為“資訊系統策略調準”)來達到與經營相結合的綜效。儘管研究者對管理運用資訊系統有高度的興趣，然而,將醫院資訊系統與經營管理調準模式的研究卻很少。由於缺少實驗的證據，因此，資訊系統策略調準的模式在理論與實務之間存在差距。在本研究中，整合了資訊系統與調準相關的理論，針對資訊系統調準的研究相關議題，發展出資訊系統策略調準的構念。並依循Venkatraman 的“調節”理論，而進一步實證檢視此ㄧ調準模式。 “調節”解釋為“資訊系統策略可以透過調節的機制來催化經營策略，以達成企業較好的績效”。

本研究的資料來源根據，是透過對台灣地區各級醫院的實地調查而來，利用以變異數為主的部份最小平方法與多元回歸分析法，來對資料進行分析。對於資訊系統策略與經營策略對經營績效的調解關係，也進行了檢驗。分析結果，研究顯示資訊系統的策略調準模式對績效有正面的影響而且對於績效的變異具備有52.4% 的解釋能力。對於醫院績效而言，在所有的模式當中，互動觀點是較佳的模式。經本研究發現，對於醫院經營管理重要而且有密切關聯的管理議題是—單就資訊系統策略調準對醫院績效的貢獻而言，就提高了8.4% 的醫院績效變異量。所以，對醫院而言更應該有的認知是：醫院必須將資訊系統資源為基礎的策略調準模式，作為經營策略與作業的導向。而不應該只是將資訊系統視為回應經營需求的功能而已。

ABSTRACT

The Relationship Between Strategic Alignment of
Information Systems and Performance Impact in Hospitals

Huang, Ying Hsiang

The Taiwan government implemented the National Health Insurance (NHI) program in 1995 to provide comprehensive and uniform health services to the entire population. The ensuring phenomenon from the implementation of the NHI program is the furious competition in the healthcare market that has become matured. To survive, hospitals need to enhance efficiency and provide high quality of care to the patients. Often, hospitals cope with external environmental changes through the choice and application of appropriate strategies. Forming strategic alignment with resources is an increasingly adopted strategy by hospitals.
The recognition of information systems (IS) as the most valuable resource has motivated hospitals to engage in their formal management. To achieve better hospitals’ performance from managing IS, management strategists recommend that hospitals relate IS management with business activities in hospitals. As a resource, IS can be related to business through alignment (in terms of strategic alignment of IS), as is applicable to other resources such as manpower resources. Despite interest in managing IS, however, there has been little or not research about aligning IS with business in hospitals. Lack of empirical evidence creates a gap between the theory and practice of strategic alignment of IS. In this study, to integrated theories about IS and alignment to develop an alignment framework and model for IS alignment research, developed a strategic alignment construct, and empirically tested the alignment model within the mediation perspectives along with the Venkatraman’s theory. Mediation was interpreted as the mechanism through which IS strategy could catalyze business strategy for the attainment of better performance.
Data from hospitals’ survey in Taiwan was analyzed using the variance-based partial least square and multiple regression method. IS strategy and business strategy in mediating the performance, the links were examined. Results indicate that strategic alignment of IS positively impact performance, explaining about 52.4% of its variation. In all models, the interactionist perspective as the better mediator of hospitals’ performance. Through exploratory, an important management implication of this study is that it may make more sense for hospitals to orientate their business strategies and operations based on their IS resources strategic alignment rather than engage in IS function as a response to business needs since this study shows such strategic alignment of IS contributed on performance with 8.4% of its variation.

TABLE OF CONTENTS

Abstract………………………………………………………………………………. ii
Acknowledgements…………………………………………………………………. iii
Table of Contents…………………………………………………………………… iv
List of Tables………………………………………………………………………… vi
List of Figures……………………………………………………………………….. viii
Chapter One: Introduction
A. Problem Statement………………………………………………………….. 1
B. Research Objectives……………………………………………………… 3
1. Research Purpose………………………………………………………. 3
2. Research Questions……………………………………………………. 4
3. Research Constructs…………………………………………………… 5
4. Research Hypotheses………………………………………………….. 7
5. Indicators for Measurement……………………………………………. 8
C. Background………………………………………………………………….. 11
1. The Business of Healthcare Innovation………………………………. 12
2. The Healthcare Information Technology Sector……………………… 15
3. Information Systems Strategic Alignment…………………………… 20
4. Strategy Measurement Approaches………………………………… 22
5. Dimensionality of the Business Strategy Construct………………… 25
6. Dimensionality of the Business Performance………………………… 27
7. Dimensionality of the IS Strategy Construct………………………… 28
8. Dimensionality of the IS Performance………………………………… 32
9. A Brief Survey of Literatures on Strategic Alignment of IS …………. 33
Chapter Two: Methodology
A. Sampling Design and Data Collection…………………………………….. 36
B. Research Design……………………………………………………………. 37
1. The Interactionist Perspective…………………………………………. 37
2. The Profile Deviation Perspective……………………………………... 38
3. The Covariation Perspective…………………………………………… 39
4. The Instrumentation About Demographic Information……….. 40
5. The Instrumentation About Indicators for Conceptual Model.. 42
C. Data Analysis………………………………………………………………... 47
D. Limitations …………………………………………………………………… 50
Chapter Three: Findings
A. Reliability of Instrument…………………………………………………….. 51
B. Description Statistics………………………………………………………... 53
1. General Demographic Information……………………………………. 54
2. The General Characteristics of Variables…………………………….. 61
C. The Correlation Coefficient………………………………………………… 68
D. The Multiple Regression…………………………………………………… 76
1. Path Coefficients on Systems Model………………………………….. 76
2. The Relationship between STROBH and HGRW……………………. 77
3. The Relationship between STROBH and HPRF…………………….. 78
4. The Relationship between STROBH and HPFM…………………….. 79
5. The Relationship between STROMS and SPFM…………………….. 81
6. The Relationship between SPFM and HGRW……………………….. 83
7. The Relationship between SPFM and HPRF………………………… 84
8. The Relationship between SPFM and HPFM………………………… 85
9. The Relationship between ALGMNT(x) and HGRW………………… 87
10. The Relationship between ALGMNT(x) and HPRF………………….. 88
11. The Relationship between ALGMNT(x) and HPFM…………………. 89
12. The Relationship between ALGMNT(x) and SPFM…………………. 91
13. The loading of STROBH and SPFM on HPFM impact………………. 93
14. The loading of STROBH, ALGMNT(x) and SPFM on HPFM impact. 95
15. The loading of STROBH, ALGMNT(-) and SPFM on HPFM impact. 97
Chapter Four: Conclusions
A. Conclusions………………………………………………………………….. 99
B. Recommendations………………………………………………………….. 102
Appendices………………………………………………………………………….. 103
A. Survey Instrument…………………………………………………………... 103
Bibliography…………………………………………………………………………. 112

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