[논문]진료정보교류 인센티브사업에 대한 이해관계자 조사연구

박하영; 옥민수; 박정선; 이혜린; 김수민; 이상일

doi:10.9716/kits.2017.16.3.017

진료정보교류 인센티브사업에 대한 이해관계자 조사연구
Stakeholder Survey on the Incentive Program to Promote the Adoption of Health Information Exchange 원문보기

한국IT서비스학회지 = Journal of Information Technology Services, v.16 no.3, 2017년, pp.17 - 45

박하영 (서울대학교 공과대학 산업공학과 협동과정 기술경영경제정책 전공) , 옥민수 (울산대학교 의과대학 울산대학교병원 예방의학과) , 박정선 (한국보건산업진흥원 DHC의료정보화팀) , 이혜린 (서울대학교 협동과정 기술경영경제정책 전공) , 김수민 (한국보건산업진흥원 DHC의료정보화팀) , 이상일 (울산대학교 의과대학 예방의학교실)

Abstract ▼ AI-Helper

Health Information Exchange (HIE) is expected to improve the quality and efficiency of care by allowing providers online access to healthcare information generated by other providers at the point of care. However, the adoption of the technology in Korea has been slow since its pilot program in 2007~2010 at Seoul National University Bundang Hospital. The objective of this study was to survey stakeholders on the incentive program for the facilitation of HIE adoption. We surveyed 39 experts representing 6 categories of stakeholders-provider, insurer, government, information service firms, customers, and medical informatics experts for the interviews. Interview questions included program objectives, program participation requirements, incentive payment method, and administrative burden for program participation. Experts indicated that the quality of care was the most important value the program should aim to achieve through the HIE adoption. They suggested that the requirements and administrative burden for participation should be kept at minimum to recruit a large number of providers to the program, which is an indicator of program success. Experts were divided on the payment method whether the incentive should be paid as a part of the fee payment scheme operated by the National Health Insurance (NHI) or should be a payment made independent of the NHI. The source of the divide was conflict of interest among stakeholders as to who pays for the program, and the insurer and consumer groups were against the NHI taking the financial burden. It appeared to be the most significant factor for the successful program launching to resolve the gap in perceptions about benefits of the technology among stakeholders and to win the willingness to pay for the program.

주제어

질의응답

핵심어	질문	논문에서 추출한 답변
	진료정보교류 기술을 통해 무엇을 기대하고 있는가?	진료정보교류(Health Information Exchange,HIE)는 건강 관련 정보를 조직들 간에 전자적으로 교환할 수 있도록 설계된 건강정보기술 인프라의 포괄적인 요소로 2017년 1월 1일자로 제정․발령된 보건복지부 고시 제2016-233호에서는 의료인이 생성한 교류문서를 의료인 간에 전자적인 방식으로 상호교환 하는 것으로 정의하고 있다(The Office of the National Coordinator for Health Information Technology of the Department of Health and Human Services, 2008; National Law Information Center, 2017). 이 정보기술은 진료과정에서 의료제공자가 환자를 진료하는 시점에 여러 기관에 산재되어 있는 환자의 건강 관련 정보 접근을 가능하게 함으로써 의료제공의 효과성과 효율성을 개선할 수 있을 것으로 기대되고 있다. 즉, 환자가 이전의 의료기관에서 받았던 진료에 관한 정보를 의료제공자가 진료시점에 매끄럽고 신속하게 조회할 수 있게 함으로써 진료에 대한 신속한 의사결정을 가능하게 하고, 중복검사를 예방하며, 처방 약물 간의 부작용을 예방하고, 진료에 참여하는 의료진 간의 의사소통을 원활히 하며, 의료제공자의 워크플로우를 개선할 수 있다는 것이다(The Organisation of Economic Co-operation and Development, 2010; Shapiro et al., 2006; Walker et al.
	진료정보교류란 무엇인가?	진료정보교류(Health Information Exchange,HIE)는 건강 관련 정보를 조직들 간에 전자적으로 교환할 수 있도록 설계된 건강정보기술 인프라의 포괄적인 요소로 2017년 1월 1일자로 제정․발령된 보건복지부 고시 제2016-233호에서는 의료인이 생성한 교류문서를 의료인 간에 전자적인 방식으로 상호교환 하는 것으로 정의하고 있다(The Office of the National Coordinator for Health Information Technology of the Department of Health and Human Services, 2008; National Law Information Center, 2017). 이 정보기술은 진료과정에서 의료제공자가 환자를 진료하는 시점에 여러 기관에 산재되어 있는 환자의 건강 관련 정보 접근을 가능하게 함으로써 의료제공의 효과성과 효율성을 개선할 수 있을 것으로 기대되고 있다.
	우리나라가 의료제공자 간 진료정보교류의 필요성이 다른 나라에 비해 큰 이유는 무엇인가?	의료기관 간의 연계를 바탕으로 하지 않는 의료전달체계를 가지고 있는 우리나라에서 의료제공자 간 진료정보교류의 필요성은 다른 나라에 비해 크다. 하지만 환자들에게 많은 의료행위를 할수록 의료제공자의 진료수익이 증가하는 행위별 수가제를 근간으로 하는 건강보험 진료비 지불제도의 영향으로 인해서 의료제공자들이 협력하여 정보를 공유할 수 있는 진료정보교류 기술 도입의 동기는 낮은 것이 현실이다.

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