資訊科技的快速變化與網際網路的興起，造就知識管理（knowledge management, KM）成為企業獲取與維持競爭優勢的重要關鍵活動。透過知識管理可讓知識工作者即時獲取所需的知識，再將這些知識轉化為企業可以活用的核心能力，創造出更多的資源及競爭力。身處在全民健康保險總額預算制度下的醫療產業，則面臨更為激烈的競爭環境。因此，台灣的醫療產業如何透過知識管理提升品質、成本、彈性、交期、服務等醫療競爭力(medical competitiveness)為各家醫療院所迫切的需求。在高度知識密集的醫療產業，醫師之知識及專業為醫院核心競爭優勢的主要來源。然而醫師龐大的工作負荷量與其高度專業自主的特質之下，醫療知識管理的推行存在著極大的障礙。綜觀醫院醫療知識管理的發展，線上學習(e-learning)友善的資訊系統環境可謂為引導醫院進入醫療知識管理系統最有效的入門工具之ㄧ。醫療專業人員可以透過線上學習系統，打破傳統空間與時間的限制，以增進醫療專業知識及技術，提昇知識管理能力，與維持醫院核心競爭力。綜合以上，醫師線上學習系統實為推行醫療知識管理、創造知識管理能力與提昇醫療競爭力的重要途徑之ㄧ。然而，相關系統的建置手段與效益評估等機制仍未臻成熟，相關研究則鮮少以醫師觀點，從需求面出發，探討醫師線上學習對於提升知識管理能力與醫療競爭力的影響。有鑒於此，本研究擬分三階段進行。第一階段以質性方法切入，探索醫師線上學習、醫療知識管理能力與醫療競爭力等相關構念的在醫療業的衡量變項，並發展初步命題。第二階段研究則以量化研究驗證前一階段發展的衡量變項之信效度，以及醫師線上學習對於醫療知識管理能力與醫療競爭力的影響。最後，第三階段以個案研究方法，承續第二階段分析結果中醫師線上學習系統對知識價值鏈造成的缺口為主題，針對院內醫師、資訊人員與圖書館人員進行焦點群體法，深入探討醫師線上學習系統對於醫療知識價值鏈各功能以及競爭要項的貢獻與弱勢之處，並提出ㄧ成功影響模式。此研究結果在衡量變項方面期待可提供後續學術研究發展問卷之依據；在醫師線上學習對於醫療知識管理能力與醫療競爭力的貢獻方面，期待可成為醫院管理者與醫學教育工作者在推動線上學習以及醫療知識管理之參考；在成功影響模式方面期待可提供醫院資訊部門與系統業者在架構醫師線上學習系統之參考；最後，本研究結果可對於醫學專科教育制度提供傳統會議與授課方式以外的另一思維。 The rapid change of information technology and internet makes knowledge management (KM) the key activity for enterprises to obtain and maintain competitive advantages. Through KM, knowledge workers can acquire knowledge rapidly and then translate the knowledge into business competence in order to create more resources and competitiveness for the enterprises. Since the healthcare industry in Taiwan has faced the global budget reimbursement system under national health insurance, the competition is not less fierce than other industries. Hence, it is imminent that healthcare organizations use KM to enhance medical quality, costs, flexibility, delivery of care and service so as to improve their competitiveness. In the knowledge-intensive industry such as healthcare, physicians’knowledge and professions are the principle source of hospitals’competitive advantages. Nevertheless, physicians’heavy work-loadings and highly professional autonomy result in big barriers to medical knowledge management. E-learning so far can be the most effective tool around knowledge management systems due to its friendly user interface. Physicians can use e-learning without space and time frames and upgrade their professional knowledge in time so as to improve their knowledge management capability and medical competitiveness. All of the above shows that e-learning is an essential approach for enhancing medical knowledge management capability and medical competitiveness. However, there is lack of prior studies concerning these issues. Therefore, this study aims to explore the associations between these issues in a holistic framework. There are three phases involved in this study. In the phase I study, literature review and in-depth interviews will be conducted to construct preliminary research propositions. According the results, a questionnaire will be developed and a survey will be employed in the phase II study. It aims to test and revise the propositions established in the phase I study. In the phase III study, a case study with focus group interviews will be used for searching out how e-learning may further be improved to make up for the knowledge value chain gaps, and meanwhile constructing a success influencing model. The study results are expected to provide as references for the managers when implementing e-learning and medical knowledge management in a hospital. The success influencing model is expected to provide a reference for information system designers who are interested in developing physician e-learning and KM systems. In addition, the results may also shed some light for those who are engaged in developing alternative ways of medical specialty education.
