學術產出-Theses

Article View/Open

Publication Export

Google ScholarTM

政大圖書館

Citation Infomation

  • No doi shows Citation Infomation
題名 遠距照護產業營運模式-以心電圖監測為例
A Study on Telemedicine Industry Business Model – Taking ECG Monitoring as an Example
作者 謝夢蝶
貢獻者 蘇瓜藤<br>陳桂恒
謝夢蝶
關鍵詞 遠距照護
心電圖監測
營運模式
Telemedicine
ECG Monitoring
Business Model
日期 2010
上傳時間 14-Oct-2011 14:38:42 (UTC+8)
摘要 隨著少子化、老年化的時代來臨,以「銀髮族」為目標客戶的產業前景看好。全世界已開發國家人口老化日趨嚴重,社會醫療成為各國財政越來越沈重的包袱,於是以提升高齡者自立能力、降低醫療負擔,提高生活品質為目的的「遠距照護產業」備受重視。相較於其它先進國家,我國遠距照護產業發展較晚。衛生署主導的「遠距照護試辦計畫」第一階試辦已完成,目前進入第二階段擴大推廣。因而,本論文探討的核心問題,在於如何建立成功的遠距照護產業營運模式。
本論文選擇遠距照護應用中的「遠距心電圖監測」作為研究標的,乃因心電圖監測技術已有成熟發展,且全世界心臟病人口日益增加,值得投資。本論文修改技術與市場二分法的研究模式,除了「產業環境」與「營運模式分析」,更將「專利」與「查驗登記制度」納入研究環節。技術、專利與查驗登記制度雖非傳統營運模式分析的重要核心,但對於發展此產品、服務,有一定的影響。由於美國遠距心電圖產監測業發展較我國成熟,本論文比較美國與台灣發展現況,並選擇兩家於美國提供遠距心電圖監測服務的LifeWatch AG與CardioNet, Inc.作為個案研究的對象。
研究結果發現,遠距心電圖監測服務在美國主要用於輔助醫師診斷心臟疾病。不受限於環境,長期連續不間斷監測心電圖的特性,使其市場表現快速成長。美國成功建構產業的關鍵在於完善的商業機制。此外,亦發現美國針對六十五歲以上高齡人口的政府保險Medicare,其給付金額對市場發產有舉足輕重的影響,值得我國政府借鏡。建議台灣應該在保護民眾生命財產安全,以及發展產業之間取得平衡,建構一個適合發展創新技術、創新服務的產業環境。
此外,研究結果發現,台灣尚未能成功發展遠距心電圖監測服務的關鍵,並非技術,而是商業模式。台灣以保守的醫院為服務窗口的營運策略,是衛生署比擬全民健保機制,推動年長者長期健康照護制度的產物,屬於社會福利的性質,與發展產業的概念背道而馳,而且成本過高。另一方面,民眾沒有長期測量生理參數的習慣,拓展市場不易,此二者為台灣長期推動服務失敗的主要原因。因此,本研究最後建議,應捨棄以醫院為中心的服務模式,設計一套能夠被民眾廣為接受的營運模式,提供彈性的價格與服務,搭配適當的宣傳,方能突破現狀。
Population aging is getting more and more serious among developed countries, as well as the extremely heavy medical treatment budgets. Consequently, governments start to think about how to make medical service more efficient by means of information technology; businessmen start to provide telemedicine service, in order to let the elder live more independently and healthier.
A pilot remote health care project, held by the Department of Health, is moving to the second stage this year. Many telemedicine service centers had been built in the hospitals at the first stage, and now government is seeking for more hospitals and companies setting up more service centers in Taiwan. This is time to check weather it is a good business model worthy of working on, or there is a better way to develop telemedicine business. Remote ECG monitoring is one of the typical telemedicine services. Many people are suffering from cardiac disease in developed countries, and there are already some successful business models in the U.S. This is the reason why this studies focuses on remote ECG monitoring.
This study takes into account technology, patent, FDA regulations, markets, and industrial environment aspects. Usually, only markets and industrial environment would be taken into account in this kinds of theses. Technology, patents, and FDA regulations, however, may have significant impact on business. The purpose of this essay is to advice to Taiwan, by comparing the difference between the U.S. model and Taiwan model, and analyzing two cases, LifeWatch AG and CardioNet, Inc..
According to the above surveys, remote ECG monitoring is mostly used for diagnosis. The key factor is the well-built U.S. medical system. The U.S. governmental health insurance, the Medicare, has huge influence on remote the ECG monitoring industry. The medical treatment system is open and well-governed, and suits for incubating new products. Although the medical system is relatively conservative in Taiwan, it is recommended that the Taiwan government should create some mechanisms that will encourage innovative telemedicine services.
There are two reasons that make remote ECG monitoring services in Taiwan is not as successful as those in the U.S. Firstly, the services are provided by hospitals. Hospitals are conservative, and services doctors are expensive. So, there are less innovative business models, and the costs rocket high. Monitoring centers should be set outside the hospitals. Secondly, patients don’t “feel” the benefit from monitoring ECG constantly, so usually they quit the services in the second month. Therefore, marketing and promotion should be taking place. Services and prices should be more flexible and cost-effective as well. At this moment, the biggest challenge of remote ECG monitoring is business model, not technology, FDA regulations, or even patents
參考文獻 壹、 中文部份
丁建元、鄭智銘(民90),心電圖原理簡介,http://designer.mech.yzu.edu.tw/article/ articles/technical/ (2001-04-04)心電圖原理簡介.htm。最後瀏覽日期:民國99年3月10日。
王梅(民99),美國醫療體制改革的困境與啟示,新視野,2010年3期,95-96。
內政部統計處(民99),九十九年第四週內政統計通報(98年底人口結構分析),http://www.moi.gov.tw/stat/news_content.aspx?sn=3779。最後瀏覽日期:民國99年10月26日。
石明鑫(民96),應用於照護空間的無線藍牙心電圖傳輸系統,亞洲大學電腦與通訊學系研究所碩士論文。
丘秋楨(民96),探討原漢獨居老人使用遠距照護系統之影響因素及智慧化發展需求評估,慈濟大學原住民健康研究所碩士論文。
古曉倩(民98),赴美國高風險醫療器材製造廠研習,http://open.nat.gov.tw/ OpenFront /report_detail.jspx?sysId=C09800431。最後瀏覽日期:民國99年3月29日。
行政院研究發展考核委員會,銀髮館焦點報導,http://elders.www.gov.tw/focus.ph p?efm_id=6。最後瀏覽日期:民國99年7月9日。
行政院經濟建設委員會(民99),2010年至2060年台灣人口推計,行政院經濟建設委員會報告((99)033.805),http://www.cepd.gov.tw/dn.aspx?uid=8966。最後瀏覽日期:民國99年10月26日。
行政院經濟建設委員會,經濟小辭典,http://www.cepd.gov.tw/m1.aspx?sNo=000 1239。最後瀏覽日期:民國99年2月26日。
行政院衛生署,遠距健康照護中心入口網,http://doh.telecare.com.tw/。最後瀏覽日期:民國99年11月12日。
行政院衛生署(民98a),97年度全民健康保險醫療統計年報,http://www.doh. gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10902&class_no=440&level_no=2。最後瀏覽日期:民國99年12月8日。
行政院衛生署(民98b),97年度國民醫療保健支出統計表,http://www.doh.gov. tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10947&level_no=2&doc_no=74048。最後瀏覽日期:民國99年12月8日。
行政院衛生署(民99年4月24日),長期照護服務發展的規劃 -「長期照護服務法」草案預計今年下半年送行政院審議,衛生署焦點新聞,http://www.doh.gov. tw/CHT2006/DM/DM2_p01.aspx?class_no=25&level_no=1&doc_no=75539。最後瀏覽日期:民國99年6月9日。
朱建芳(民97),經濟部「健康照護創新服務應用」推動現況,http://www.tvca. org.tw/moea_idb/industry/970702-1.pdf。最後瀏覽日期:民國99年11月13日。
何彥毅(民96),遠距健康照護產業營運模式分析研究,國立台灣大學管理學院碩士在職專班高階公共管理組碩士論文。
沈能元(民92年12月6日),「安心卡」40秒傳訊心電圖,蘋果日報,http://tw. nextmedia.com/applenews/article/art_id/548783/IssueID/20031206。最後瀏覽日期:民國99年10月25日。
郭立旻(民98),台灣博碩士論文在遠距照護上之研究現況與發展趨勢,國立台北護理學院資訊管理研究所碩士論文。
徐業良(民97),老人福祉科技與遠距居家照護技術,台中:滄海書局。
國立台灣科學教育館,心臟的構造與功能取自,http://activity.ntsec.gov.tw/lifeworld /body_c6.html。最後瀏覽日期:民國99年3月10日。
陳乃塘(民96),醫療電子連結無線通訊 BAN催生健康管理,新通訊元件雜誌,79,《技術前瞻》,http://www.2cm.com.tw/technologyshow_conten t.asp?sn=0709060007。最後瀏覽日期:民國99年11月13日。
陳敬旻(民94),無線心電圖測量系統及其在居家保健之應用,國立成功大學電機工程學系碩士論文。
張乃文(民98),國外經驗探討台灣醫事規範因應遠距照護發展之調整,科技法律透析,21卷12期,46–59。
張仁耀(民96),遠距照護系統之研製-以竹山秀傳醫院U-Care系統為例,南開技術學院福祉科技與服務管理研究所碩士論文。
張慈映(民98a),心電圖計應用市場分析,工業局智慧型醫療電子產業技術推廣與輔導計畫,www.bmes.org.tw/FCKupload/File/IEK_10.pdf。最後瀏覽日期:民國99年11月10日。
張慈映(民98b),遠距健康照護市場,工業局智慧型醫療電子產業技術推廣與輔導計畫,www.bmes.org.tw/FCKupload/File/IEK_08.pd。最後瀏覽日期:民國99年1月25日。
張慈映(民98c),遠距照護(telecare)產業發展機會與挑戰說明會,無線射頻辨識(RFID)產業無線感測網路(WSN)用於遠距照護產業發展之機會與挑戰說明會論文集,經濟部中小企業處。
張慈映、吳心如(民96),探討國內醫療器材查驗登記制度與他國之差異以及對產業之影響,新竹縣:工研院。
許熾榮(民95),銀髮族遠距照護服務產業之發展,國民教育,45卷2期,73-74。
資策會,無限網路技術應用於遠距醫療照護實務班,http://www.iiiedu.org.tw/ites/ HEAL.htm。最後瀏覽日期:民國99年2月26日。
蔣明富(民97),居家遠距照護:分析一個新的營運模式,國立台灣大學管理學院在職專班高階公共管理組碩士論文。
蔡淑鳳、王秀紅(民97),台灣長期照護政策發展,護理雜誌,55卷4期,24-29。
謝柏宏(民97年10月15日),遠距醫療爭取修法鬆綁,經濟日報,D8版。
營養師法(民93年5月5日),取自全國法規資料庫,http://law.moj.gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。
藥物製造工廠設廠標準(民99年2月26日),取自全國法規資料庫,http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。
藥物製造業者檢查辦法(民97年2月20日),取自全國法規資料庫,http://law.moj. gov.tw/LawClass/LawAll.aspx?PCode=L0030009。最後瀏覽日期:民國99年6月9日。
藥事法(民95年5月30日),取自全國法規資料庫,http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。
醫師法(民98年5月13日),取自全國法規資料庫,http://law.moj.gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。
醫事檢驗法(民96年1月29日),取自全國法規資料庫,http://law.moj.gov.tw/in dex.aspx。最後瀏覽日期:民國99年6月9日。
醫療器材管理辦法(民98年10月2日),取自全國法規資料庫。http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。
醫療器材查驗登記審查準則(民95年4月12日),取自全國法規資料庫,http://law. moj.gov.tw/LawClass/LawContent.aspx?PCODE=L0030055。最後瀏覽日期:民國99年6月9日。
Health Level Seven Taiwan,HL7-Taiwan,http://www.hl7.org.tw/index.php。最後瀏覽日期:民國99年6月8日。
IBM,實踐「智慧台灣」 IBM 在台成立全球首座「智慧生活前瞻研究中心」,http://www.ibm.com/news/tw/zh/2009/12/21/o010761l75304f9 5.html。最後瀏覽日期:民國99年2月3日。
TFDA(民98),查驗登記案件送件方式,http://www.fda.gov.tw/content.aspx?site_ content_sn=312。最後瀏覽日期:民國99年5月27日。
TFDA(民99),第二、三等級一般醫療器材查驗登記專區,http://www.fda.gov.tw/content.aspx?site_ content_sn=2080。最後瀏覽日期:民國99年12月8日。
貳、 英文部份
American Medical Association. AMA – About CPT®. Retrieved October 30, 2010, http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt.shtml
Boston Scientific Corporation. Boston Scientific::Home. Retrieved August 6, 2010, from http://www.bostonscientific.com/home.bsci
European Committee for Standardization.(2005). Current and future standardization issues in the e-Health domain: Achieving interoperability.Retrieved June 8, 2010, from http://publicaa.ansi.org/sites/apdl/Documents/Standards%20Activities/Healt hcare%20Informatics%20Technology%20Standards%20Panel/Standardization%20Committees/International%20Landscape/eHealthStandardizationReport-Part1-finalversion%20-%202005-03-011.pdf
CardioNet, Inc. (2009). 10-K. Retrieved October, 30, 2010, from http://investors.cardi onet.com/phoenix.zhtml?c=214891&p=irol-sec&control_symbol=
CardioNet, Inc. (2010). 10-K. Retrieved October, 30, 2010, from http://investors.cardi onet.com/phoenix.zhtml?c=214891&p=irol-sec&control_symbol=
Cardiac Science Corporation. (2009). 2008 Annual report. Retrieved October 27, 2010 from http://ir.cardiacscience.com/annuals.cfm
Cardiac Science Corporation. (2010). 2009 Annual report. Retrieved October 27, 2010 from http://ir.cardiacscience.com/annuals.cfm
CHD-UK©. Non-invasive Test. Retrieved October 26, 2010, from http://congenital-heart-defects.co.uk/noninvasivetests.aspx
European Committee for Standardization. About us. Retrieved June 8, 2010, from http://www.cen.eu/cen/AboutUs/Pages/default.aspx
European Committee for Standardization. eHealth Focus Group. Retrieved June 8, 2010, from http://www.cen.eu/cen/Sectors/Sectors/ISSS/Activity/Pages/eHealth _FG.aspx
Federal Food, Drug, and Cosmetic ACT, 21 U.S.C. § 301 et seq. (2004). Retrieved November, 10, 2010, from Cornell University Law School http://www.law. cornell.edu/uscode/21/usc_sup_01_21_10_9.html
Forst & Sullivan. (2010). North American cardiac monitoring product market outlook. Report introduction retrieved from http://www.frost.com/prod/servlet/ press-release.pag?Src=RSS&docid=209319781
Health Hero Network, Inc. Official Website. Retrieved August 6, 2010, from https://www.healthhero.com/about/about_health_hero.html
Health Level Seven International. About HL7.Retrived June 8, 2010, from http://ww w.hl7.org/about/index.cfm?ref=nav
Koninklijke Philips Electronics N.V. MyHeart project. Retrived December 28, 2009, from http://www.research.philips.com/technologies/projects/heartcycle/myheart- gen.html
LifeWatch AG. (2001). Annual report 2000. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2009/ar-2009.pdf
LifeWatch AG. (2002). Annual report 2001. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2001/ar-2001.pdf
LifeWatch AG. (2003). Annual report 2002. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2002/ar-2002.pdf
LifeWatch AG. (2004). Annual report 2003. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2003/ar-2003.pdf
LifeWatch AG. (2005). Annual report 2004. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2004/ar-2004.pdf
LifeWatch AG. (2006). Annual report 2005. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2005/ar-2005.pdf
LifeWatch AG. (2007). Annual report 2006. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2006/ar-2006.pdf
LifeWatch AG. (2008). Annual report 2007. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2007/ar-2007.pdf
LifeWatch AG. (2009). Annual report 2008. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2008/ar-2008.pdf
LifeWatch AG. (2010). Annual report 2009. Retrieved October 18, 2010, from http://ww w.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2009/ar-2009.pdf
Markets and Markets. (2010a). Global diagnostic ECG market. Rretrieved October 19, 2010, from http://www.giichinese.com.tw/report/mama117283-diagnostic- ecg_ toc.html
Markets and Markets. (2010b). Global diagnostic ECG market (2010 - 2015). Retrieved October 19, 2010,from http://www.researchandmarkets.com/ reportinfo.asp?report_id=1402193&tracker=related
Medtronic, Inc. Medtronic’s life-changing therapies are transforming the face of chornic disease. Retrieved August 6, 2010, from http://www.medtronic.com/ about-medtronic/
Microsoft Corporation. Microsoft software and solutions for the health industry. Retrived January 25, 2010, from http://www.microsoft.com/industry/health care/default.mspx
Morton Medical Limited. Welch Allyn cardioperfect exercise ECG. Retrieved October 26, 2010, from http://www.mortonmedical.co.uk/Welch_Allyn_C ardioperfect_Exercise_ECG~p~20.htm
Motorola, Inc. Motorola Home – Motorola USA. Retrieved August 6, 2010, from http://www. motorola.com/Consumers/US-EN/GLP
Natick, Mass. (2010, June 10). Boston Scientific Announces FDA Approval for Latitude® Patient Management System software Upgrade. PCRonline. Retrieved November 12, 2010, from http://www.pcronline.com/News/Press-releases/Bosto n-Scientific-Announces-FDA-Approval-for-LATITUDE-R-Patient-Management-System-Software-Upgrade2
OECD. (2006). Projecting OECD health and long-term care expenditure: what are the main drivers? Retrieved November 29, 2010, from http://www.oecd.org/ dataoecd/57/7/36085940.pdf
ResMed, Ltd. ResMed. Retrieved August 6, 2010, from http://www.resmed. com/ap/index.html
Robert Bosch LLC. (2009). Robert Bosch North America, Healthways Announce Availability of Single License for Joint Patent Portfolios. Retrieved Agust 6, 2010, from http://www.healthbuddy.com/content/language1/html/6001_ENU_XHTML. aspx
U.S. Food and Drug Administration.(2002). General principles of software validation; final guidance for industry and FDA staff. Retrieved March 18, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm085281.htm
U.S. Food and Drug Administration. (2003). Class II special control guidance document: arrhythmia detector and alarm. Retrieved June 1, 2010, from http:// www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm072671.htm
U.S. Food and Drug Administration. (2005). Guidance for the content of premarket submissions for software contained in medical devices. Retrieved March 18, 2010, from http://www.fda.gov/downloads/MedicalDevices/DeviceRegulation andGuidance/GuidanceDocuments/UCM089593.pdf
U.S. Food and Drug Administration. (2009a). Device advice: investigational device exemption (IDE). Retreived March 29, 2010, from http://www.fda.gov/Medical Devices/DeviceRegulationandGuidance/HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/default.htm
U.S. Food and Drug Administration. (2009b). How to prepare a Special 510(k). Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/Device RegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/ucm134573.htm
U.S. Food and Drug Administration.(2009c). IDE application. Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/ucm046706.htm
U.S. Food and Drug Administration.(2009d). IDE approval process. Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGui dance/HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/ucm046164.htm
U.S. Food and Drug Administration.(2009e). Premarket approval(PMA). Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/default.htm
U.S. Food and Drug Administration.(2009f). Premarket notification (510k). Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/default.htm
U.S. Food and Drug Administration. (2009g). Quality systems regulation. Retrieved March 20, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/PostmarketRequirements/QualitySystemsRegulations/default.htm
U.S. Food and Drug Administration. (2010a). How to market your device. Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/default.htm
U.S. Food and Drug Administration. (2010b). Premarket notification [510(k)] Review Fees. Retrieved December 1, 2010, from http://www.fda.gov/MedicalDevices/ DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/ucm134566.htm。
U.S. Food and Drug Administration. (2010c). PMA review fees. Retreived December 4, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/ucm048161.htm
U.S. National Library of Medicine. ECG: MedlinePlus medical encyclopedia image. Retrieved October 26, 2010, from http://www.nlm.nih.gov/medlineplus/ency/im agepages/1135.htm
描述 碩士
國立政治大學
智慧財產研究所
96361003
99
資料來源 http://thesis.lib.nccu.edu.tw/record/#G0963610031
資料類型 thesis
dc.contributor.advisor 蘇瓜藤<br>陳桂恒zh_TW
dc.contributor.author (Authors) 謝夢蝶zh_TW
dc.creator (作者) 謝夢蝶zh_TW
dc.date (日期) 2010en_US
dc.date.accessioned 14-Oct-2011 14:38:42 (UTC+8)-
dc.date.available 14-Oct-2011 14:38:42 (UTC+8)-
dc.date.issued (上傳時間) 14-Oct-2011 14:38:42 (UTC+8)-
dc.identifier (Other Identifiers) G0963610031en_US
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/51695-
dc.description (描述) 碩士zh_TW
dc.description (描述) 國立政治大學zh_TW
dc.description (描述) 智慧財產研究所zh_TW
dc.description (描述) 96361003zh_TW
dc.description (描述) 99zh_TW
dc.description.abstract (摘要) 隨著少子化、老年化的時代來臨,以「銀髮族」為目標客戶的產業前景看好。全世界已開發國家人口老化日趨嚴重,社會醫療成為各國財政越來越沈重的包袱,於是以提升高齡者自立能力、降低醫療負擔,提高生活品質為目的的「遠距照護產業」備受重視。相較於其它先進國家,我國遠距照護產業發展較晚。衛生署主導的「遠距照護試辦計畫」第一階試辦已完成,目前進入第二階段擴大推廣。因而,本論文探討的核心問題,在於如何建立成功的遠距照護產業營運模式。
本論文選擇遠距照護應用中的「遠距心電圖監測」作為研究標的,乃因心電圖監測技術已有成熟發展,且全世界心臟病人口日益增加,值得投資。本論文修改技術與市場二分法的研究模式,除了「產業環境」與「營運模式分析」,更將「專利」與「查驗登記制度」納入研究環節。技術、專利與查驗登記制度雖非傳統營運模式分析的重要核心,但對於發展此產品、服務,有一定的影響。由於美國遠距心電圖產監測業發展較我國成熟,本論文比較美國與台灣發展現況,並選擇兩家於美國提供遠距心電圖監測服務的LifeWatch AG與CardioNet, Inc.作為個案研究的對象。
研究結果發現,遠距心電圖監測服務在美國主要用於輔助醫師診斷心臟疾病。不受限於環境,長期連續不間斷監測心電圖的特性,使其市場表現快速成長。美國成功建構產業的關鍵在於完善的商業機制。此外,亦發現美國針對六十五歲以上高齡人口的政府保險Medicare,其給付金額對市場發產有舉足輕重的影響,值得我國政府借鏡。建議台灣應該在保護民眾生命財產安全,以及發展產業之間取得平衡,建構一個適合發展創新技術、創新服務的產業環境。
此外,研究結果發現,台灣尚未能成功發展遠距心電圖監測服務的關鍵,並非技術,而是商業模式。台灣以保守的醫院為服務窗口的營運策略,是衛生署比擬全民健保機制,推動年長者長期健康照護制度的產物,屬於社會福利的性質,與發展產業的概念背道而馳,而且成本過高。另一方面,民眾沒有長期測量生理參數的習慣,拓展市場不易,此二者為台灣長期推動服務失敗的主要原因。因此,本研究最後建議,應捨棄以醫院為中心的服務模式,設計一套能夠被民眾廣為接受的營運模式,提供彈性的價格與服務,搭配適當的宣傳,方能突破現狀。
zh_TW
dc.description.abstract (摘要) Population aging is getting more and more serious among developed countries, as well as the extremely heavy medical treatment budgets. Consequently, governments start to think about how to make medical service more efficient by means of information technology; businessmen start to provide telemedicine service, in order to let the elder live more independently and healthier.
A pilot remote health care project, held by the Department of Health, is moving to the second stage this year. Many telemedicine service centers had been built in the hospitals at the first stage, and now government is seeking for more hospitals and companies setting up more service centers in Taiwan. This is time to check weather it is a good business model worthy of working on, or there is a better way to develop telemedicine business. Remote ECG monitoring is one of the typical telemedicine services. Many people are suffering from cardiac disease in developed countries, and there are already some successful business models in the U.S. This is the reason why this studies focuses on remote ECG monitoring.
This study takes into account technology, patent, FDA regulations, markets, and industrial environment aspects. Usually, only markets and industrial environment would be taken into account in this kinds of theses. Technology, patents, and FDA regulations, however, may have significant impact on business. The purpose of this essay is to advice to Taiwan, by comparing the difference between the U.S. model and Taiwan model, and analyzing two cases, LifeWatch AG and CardioNet, Inc..
According to the above surveys, remote ECG monitoring is mostly used for diagnosis. The key factor is the well-built U.S. medical system. The U.S. governmental health insurance, the Medicare, has huge influence on remote the ECG monitoring industry. The medical treatment system is open and well-governed, and suits for incubating new products. Although the medical system is relatively conservative in Taiwan, it is recommended that the Taiwan government should create some mechanisms that will encourage innovative telemedicine services.
There are two reasons that make remote ECG monitoring services in Taiwan is not as successful as those in the U.S. Firstly, the services are provided by hospitals. Hospitals are conservative, and services doctors are expensive. So, there are less innovative business models, and the costs rocket high. Monitoring centers should be set outside the hospitals. Secondly, patients don’t “feel” the benefit from monitoring ECG constantly, so usually they quit the services in the second month. Therefore, marketing and promotion should be taking place. Services and prices should be more flexible and cost-effective as well. At this moment, the biggest challenge of remote ECG monitoring is business model, not technology, FDA regulations, or even patents
en_US
dc.description.tableofcontents 第一章 緒論 1
第一節 研究背景 1
第二節 研究目的 2
第三節 研究方法 2
第四節 研究範圍與限制 3
第二章 文獻探討 5
第一節 遠距照護產業 5
壹、 遠距照護產業之定義與相關辭彙 5
貳、 遠距照護之應用類別 7
參、 我國遠距照護相關政策 9
肆、 遠距照護相關法規 12
伍、 醫療器材查驗登記制度之國際趨勢 13
陸、 我國遠距照護產業現況 14
第二節 心電圖 15
壹、 心電圖簡介 15
貳、 心電圖於臨床上的應用 16
第三章 產品定義與技術簡介 17
第一節 遠距照護系統架構 17
第二節 遠距照護技術類型 18
壹、 器材與設備 19
貳、 網路通訊技術 19
參、 伺服器 20
肆、 應用軟體 20
第三節 遠距照護心電圖監測系統產品定義 21
第四節 互通性與標準之發展 24
第四章 查驗登記制度 27
第一節 美國法規 27
壹、 美國醫療器材管理制度 27
貳、 上市前通知(PMN, 510(k)) 31
參、 上市前許可(PMA)簡介 33
肆、 醫療器材臨床試驗(IDE) 35
伍、 軟體確效 37
陸、 品質系統規範(QSR)與優良製造規範(CGMP) 40
第二節 台灣法規 41
壹、 台灣醫療器材管理制度 41
貳、 優良製造規範 43
參、 醫療器材查驗登記制度 45
第三節 遠距照護心電圖監測系統之法規適用 49
壹、 我國與美國分類分級 49
貳、 我國與美國上市許可之規定 53
參、 法規適用之商業決策 54
第五章 專利分析 57
第一節 遠距心電圖監測系統之核心技術與核心專利 57
第二節 遠距心電圖監測系統之專利現況與專利應用 58
壹、 專利現況 58
貳、 營收貢獻 59
參、 專利訴訟 60
第三節 分析與討論 62
第六章 產業環境與營運模式 64
第一節 產品分析 64
壹、 心電圖計種類 64
貳、 遠距心電圖監測系統的產品定位 66
第二節 市場分析 67
壹、 遠距心電圖監測服務應用範圍 67
貳、 市場區隔 67
參、 市場規模 70
第三節 產業鏈 73
壹、 遠距照護產業之產業鏈 73
貳、 遠距心電圖監測產業之產業鏈 74
第四節 營運廠商 75
壹、 美國遠距心電圖監測營運廠商 75
貳、 台灣遠距心電圖監測營運廠商 76
第五節 營運模式 76
壹、 美國遠距心電圖監測產業營運模式 76
貳、 台灣遠距心電圖監測產業營運模式 78
第六節 結論 80
第七章 個案研究 81
第一節 LifeWatch AG 81
壹、 公司簡介 81
貳、 經營策略 84
參、 遠距心電圖監測服務運作模式 86
肆、 心電圖監測產品與技術沿革 87
伍、 專利策略 95
陸、 結論 101
第二節 CardionNet, Inc. 102
壹、 公司簡介 102
貳、 經營策略 104
參、 遠距心電圖監測服務運作模式 106
肆、 產品與技術沿革 106
伍、 專利策略 107
陸、 結論 112
第八章 結論與建議 114
第一節 結論 114
第二節 建議 116
參考文獻 122
zh_TW
dc.language.iso en_US-
dc.source.uri (資料來源) http://thesis.lib.nccu.edu.tw/record/#G0963610031en_US
dc.subject (關鍵詞) 遠距照護zh_TW
dc.subject (關鍵詞) 心電圖監測zh_TW
dc.subject (關鍵詞) 營運模式zh_TW
dc.subject (關鍵詞) Telemedicineen_US
dc.subject (關鍵詞) ECG Monitoringen_US
dc.subject (關鍵詞) Business Modelen_US
dc.title (題名) 遠距照護產業營運模式-以心電圖監測為例zh_TW
dc.title (題名) A Study on Telemedicine Industry Business Model – Taking ECG Monitoring as an Exampleen_US
dc.type (資料類型) thesisen
dc.relation.reference (參考文獻) 壹、 中文部份zh_TW
dc.relation.reference (參考文獻) 丁建元、鄭智銘(民90),心電圖原理簡介,http://designer.mech.yzu.edu.tw/article/ articles/technical/ (2001-04-04)心電圖原理簡介.htm。最後瀏覽日期:民國99年3月10日。zh_TW
dc.relation.reference (參考文獻) 王梅(民99),美國醫療體制改革的困境與啟示,新視野,2010年3期,95-96。zh_TW
dc.relation.reference (參考文獻) 內政部統計處(民99),九十九年第四週內政統計通報(98年底人口結構分析),http://www.moi.gov.tw/stat/news_content.aspx?sn=3779。最後瀏覽日期:民國99年10月26日。zh_TW
dc.relation.reference (參考文獻) 石明鑫(民96),應用於照護空間的無線藍牙心電圖傳輸系統,亞洲大學電腦與通訊學系研究所碩士論文。zh_TW
dc.relation.reference (參考文獻) 丘秋楨(民96),探討原漢獨居老人使用遠距照護系統之影響因素及智慧化發展需求評估,慈濟大學原住民健康研究所碩士論文。zh_TW
dc.relation.reference (參考文獻) 古曉倩(民98),赴美國高風險醫療器材製造廠研習,http://open.nat.gov.tw/ OpenFront /report_detail.jspx?sysId=C09800431。最後瀏覽日期:民國99年3月29日。zh_TW
dc.relation.reference (參考文獻) 行政院研究發展考核委員會,銀髮館焦點報導,http://elders.www.gov.tw/focus.ph p?efm_id=6。最後瀏覽日期:民國99年7月9日。zh_TW
dc.relation.reference (參考文獻) 行政院經濟建設委員會(民99),2010年至2060年台灣人口推計,行政院經濟建設委員會報告((99)033.805),http://www.cepd.gov.tw/dn.aspx?uid=8966。最後瀏覽日期:民國99年10月26日。zh_TW
dc.relation.reference (參考文獻) 行政院經濟建設委員會,經濟小辭典,http://www.cepd.gov.tw/m1.aspx?sNo=000 1239。最後瀏覽日期:民國99年2月26日。zh_TW
dc.relation.reference (參考文獻) 行政院衛生署,遠距健康照護中心入口網,http://doh.telecare.com.tw/。最後瀏覽日期:民國99年11月12日。zh_TW
dc.relation.reference (參考文獻) 行政院衛生署(民98a),97年度全民健康保險醫療統計年報,http://www.doh. gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10902&class_no=440&level_no=2。最後瀏覽日期:民國99年12月8日。zh_TW
dc.relation.reference (參考文獻) 行政院衛生署(民98b),97年度國民醫療保健支出統計表,http://www.doh.gov. tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10947&level_no=2&doc_no=74048。最後瀏覽日期:民國99年12月8日。zh_TW
dc.relation.reference (參考文獻) 行政院衛生署(民99年4月24日),長期照護服務發展的規劃 -「長期照護服務法」草案預計今年下半年送行政院審議,衛生署焦點新聞,http://www.doh.gov. tw/CHT2006/DM/DM2_p01.aspx?class_no=25&level_no=1&doc_no=75539。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 朱建芳(民97),經濟部「健康照護創新服務應用」推動現況,http://www.tvca. org.tw/moea_idb/industry/970702-1.pdf。最後瀏覽日期:民國99年11月13日。zh_TW
dc.relation.reference (參考文獻) 何彥毅(民96),遠距健康照護產業營運模式分析研究,國立台灣大學管理學院碩士在職專班高階公共管理組碩士論文。zh_TW
dc.relation.reference (參考文獻) 沈能元(民92年12月6日),「安心卡」40秒傳訊心電圖,蘋果日報,http://tw. nextmedia.com/applenews/article/art_id/548783/IssueID/20031206。最後瀏覽日期:民國99年10月25日。zh_TW
dc.relation.reference (參考文獻) 郭立旻(民98),台灣博碩士論文在遠距照護上之研究現況與發展趨勢,國立台北護理學院資訊管理研究所碩士論文。zh_TW
dc.relation.reference (參考文獻) 徐業良(民97),老人福祉科技與遠距居家照護技術,台中:滄海書局。zh_TW
dc.relation.reference (參考文獻) 國立台灣科學教育館,心臟的構造與功能取自,http://activity.ntsec.gov.tw/lifeworld /body_c6.html。最後瀏覽日期:民國99年3月10日。zh_TW
dc.relation.reference (參考文獻) 陳乃塘(民96),醫療電子連結無線通訊 BAN催生健康管理,新通訊元件雜誌,79,《技術前瞻》,http://www.2cm.com.tw/technologyshow_conten t.asp?sn=0709060007。最後瀏覽日期:民國99年11月13日。zh_TW
dc.relation.reference (參考文獻) 陳敬旻(民94),無線心電圖測量系統及其在居家保健之應用,國立成功大學電機工程學系碩士論文。zh_TW
dc.relation.reference (參考文獻) 張乃文(民98),國外經驗探討台灣醫事規範因應遠距照護發展之調整,科技法律透析,21卷12期,46–59。zh_TW
dc.relation.reference (參考文獻) 張仁耀(民96),遠距照護系統之研製-以竹山秀傳醫院U-Care系統為例,南開技術學院福祉科技與服務管理研究所碩士論文。zh_TW
dc.relation.reference (參考文獻) 張慈映(民98a),心電圖計應用市場分析,工業局智慧型醫療電子產業技術推廣與輔導計畫,www.bmes.org.tw/FCKupload/File/IEK_10.pdf。最後瀏覽日期:民國99年11月10日。zh_TW
dc.relation.reference (參考文獻) 張慈映(民98b),遠距健康照護市場,工業局智慧型醫療電子產業技術推廣與輔導計畫,www.bmes.org.tw/FCKupload/File/IEK_08.pd。最後瀏覽日期:民國99年1月25日。zh_TW
dc.relation.reference (參考文獻) 張慈映(民98c),遠距照護(telecare)產業發展機會與挑戰說明會,無線射頻辨識(RFID)產業無線感測網路(WSN)用於遠距照護產業發展之機會與挑戰說明會論文集,經濟部中小企業處。zh_TW
dc.relation.reference (參考文獻) 張慈映、吳心如(民96),探討國內醫療器材查驗登記制度與他國之差異以及對產業之影響,新竹縣:工研院。zh_TW
dc.relation.reference (參考文獻) 許熾榮(民95),銀髮族遠距照護服務產業之發展,國民教育,45卷2期,73-74。zh_TW
dc.relation.reference (參考文獻) 資策會,無限網路技術應用於遠距醫療照護實務班,http://www.iiiedu.org.tw/ites/ HEAL.htm。最後瀏覽日期:民國99年2月26日。zh_TW
dc.relation.reference (參考文獻) 蔣明富(民97),居家遠距照護:分析一個新的營運模式,國立台灣大學管理學院在職專班高階公共管理組碩士論文。zh_TW
dc.relation.reference (參考文獻) 蔡淑鳳、王秀紅(民97),台灣長期照護政策發展,護理雜誌,55卷4期,24-29。zh_TW
dc.relation.reference (參考文獻) 謝柏宏(民97年10月15日),遠距醫療爭取修法鬆綁,經濟日報,D8版。zh_TW
dc.relation.reference (參考文獻) 營養師法(民93年5月5日),取自全國法規資料庫,http://law.moj.gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 藥物製造工廠設廠標準(民99年2月26日),取自全國法規資料庫,http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 藥物製造業者檢查辦法(民97年2月20日),取自全國法規資料庫,http://law.moj. gov.tw/LawClass/LawAll.aspx?PCode=L0030009。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 藥事法(民95年5月30日),取自全國法規資料庫,http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 醫師法(民98年5月13日),取自全國法規資料庫,http://law.moj.gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 醫事檢驗法(民96年1月29日),取自全國法規資料庫,http://law.moj.gov.tw/in dex.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 醫療器材管理辦法(民98年10月2日),取自全國法規資料庫。http://law.moj. gov.tw/ index.aspx。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) 醫療器材查驗登記審查準則(民95年4月12日),取自全國法規資料庫,http://law. moj.gov.tw/LawClass/LawContent.aspx?PCODE=L0030055。最後瀏覽日期:民國99年6月9日。zh_TW
dc.relation.reference (參考文獻) Health Level Seven Taiwan,HL7-Taiwan,http://www.hl7.org.tw/index.php。最後瀏覽日期:民國99年6月8日。zh_TW
dc.relation.reference (參考文獻) IBM,實踐「智慧台灣」 IBM 在台成立全球首座「智慧生活前瞻研究中心」,http://www.ibm.com/news/tw/zh/2009/12/21/o010761l75304f9 5.html。最後瀏覽日期:民國99年2月3日。zh_TW
dc.relation.reference (參考文獻) TFDA(民98),查驗登記案件送件方式,http://www.fda.gov.tw/content.aspx?site_ content_sn=312。最後瀏覽日期:民國99年5月27日。zh_TW
dc.relation.reference (參考文獻) TFDA(民99),第二、三等級一般醫療器材查驗登記專區,http://www.fda.gov.tw/content.aspx?site_ content_sn=2080。最後瀏覽日期:民國99年12月8日。zh_TW
dc.relation.reference (參考文獻) 貳、 英文部份zh_TW
dc.relation.reference (參考文獻) American Medical Association. AMA – About CPT®. Retrieved October 30, 2010, http://www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/cpt/about-cpt.shtmlzh_TW
dc.relation.reference (參考文獻) Boston Scientific Corporation. Boston Scientific::Home. Retrieved August 6, 2010, from http://www.bostonscientific.com/home.bscizh_TW
dc.relation.reference (參考文獻) European Committee for Standardization.(2005). Current and future standardization issues in the e-Health domain: Achieving interoperability.Retrieved June 8, 2010, from http://publicaa.ansi.org/sites/apdl/Documents/Standards%20Activities/Healt hcare%20Informatics%20Technology%20Standards%20Panel/Standardization%20Committees/International%20Landscape/eHealthStandardizationReport-Part1-finalversion%20-%202005-03-011.pdfzh_TW
dc.relation.reference (參考文獻) CardioNet, Inc. (2009). 10-K. Retrieved October, 30, 2010, from http://investors.cardi onet.com/phoenix.zhtml?c=214891&p=irol-sec&control_symbol=zh_TW
dc.relation.reference (參考文獻) CardioNet, Inc. (2010). 10-K. Retrieved October, 30, 2010, from http://investors.cardi onet.com/phoenix.zhtml?c=214891&p=irol-sec&control_symbol=zh_TW
dc.relation.reference (參考文獻) Cardiac Science Corporation. (2009). 2008 Annual report. Retrieved October 27, 2010 from http://ir.cardiacscience.com/annuals.cfmzh_TW
dc.relation.reference (參考文獻) Cardiac Science Corporation. (2010). 2009 Annual report. Retrieved October 27, 2010 from http://ir.cardiacscience.com/annuals.cfmzh_TW
dc.relation.reference (參考文獻) CHD-UK©. Non-invasive Test. Retrieved October 26, 2010, from http://congenital-heart-defects.co.uk/noninvasivetests.aspxzh_TW
dc.relation.reference (參考文獻) European Committee for Standardization. About us. Retrieved June 8, 2010, from http://www.cen.eu/cen/AboutUs/Pages/default.aspxzh_TW
dc.relation.reference (參考文獻) European Committee for Standardization. eHealth Focus Group. Retrieved June 8, 2010, from http://www.cen.eu/cen/Sectors/Sectors/ISSS/Activity/Pages/eHealth _FG.aspxzh_TW
dc.relation.reference (參考文獻) Federal Food, Drug, and Cosmetic ACT, 21 U.S.C. § 301 et seq. (2004). Retrieved November, 10, 2010, from Cornell University Law School http://www.law. cornell.edu/uscode/21/usc_sup_01_21_10_9.htmlzh_TW
dc.relation.reference (參考文獻) Forst & Sullivan. (2010). North American cardiac monitoring product market outlook. Report introduction retrieved from http://www.frost.com/prod/servlet/ press-release.pag?Src=RSS&docid=209319781zh_TW
dc.relation.reference (參考文獻) Health Hero Network, Inc. Official Website. Retrieved August 6, 2010, from https://www.healthhero.com/about/about_health_hero.htmlzh_TW
dc.relation.reference (參考文獻) Health Level Seven International. About HL7.Retrived June 8, 2010, from http://ww w.hl7.org/about/index.cfm?ref=navzh_TW
dc.relation.reference (參考文獻) Koninklijke Philips Electronics N.V. MyHeart project. Retrived December 28, 2009, from http://www.research.philips.com/technologies/projects/heartcycle/myheart- gen.htmlzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2001). Annual report 2000. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2009/ar-2009.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2002). Annual report 2001. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2001/ar-2001.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2003). Annual report 2002. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2002/ar-2002.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2004). Annual report 2003. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2003/ar-2003.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2005). Annual report 2004. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2004/ar-2004.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2006). Annual report 2005. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2005/ar-2005.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2007). Annual report 2006. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2006/ar-2006.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2008). Annual report 2007. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2007/ar-2007.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2009). Annual report 2008. Retrieved October 18, 2010, from http://www.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2008/ar-2008.pdfzh_TW
dc.relation.reference (參考文獻) LifeWatch AG. (2010). Annual report 2009. Retrieved October 18, 2010, from http://ww w.irlifewatch.com/lifewatch/financial-publications/annual-reports/annual-report-2009/ar-2009.pdfzh_TW
dc.relation.reference (參考文獻) Markets and Markets. (2010a). Global diagnostic ECG market. Rretrieved October 19, 2010, from http://www.giichinese.com.tw/report/mama117283-diagnostic- ecg_ toc.htmlzh_TW
dc.relation.reference (參考文獻) Markets and Markets. (2010b). Global diagnostic ECG market (2010 - 2015). Retrieved October 19, 2010,from http://www.researchandmarkets.com/ reportinfo.asp?report_id=1402193&tracker=relatedzh_TW
dc.relation.reference (參考文獻) Medtronic, Inc. Medtronic’s life-changing therapies are transforming the face of chornic disease. Retrieved August 6, 2010, from http://www.medtronic.com/ about-medtronic/zh_TW
dc.relation.reference (參考文獻) Microsoft Corporation. Microsoft software and solutions for the health industry. Retrived January 25, 2010, from http://www.microsoft.com/industry/health care/default.mspxzh_TW
dc.relation.reference (參考文獻) Morton Medical Limited. Welch Allyn cardioperfect exercise ECG. Retrieved October 26, 2010, from http://www.mortonmedical.co.uk/Welch_Allyn_C ardioperfect_Exercise_ECG~p~20.htmzh_TW
dc.relation.reference (參考文獻) Motorola, Inc. Motorola Home – Motorola USA. Retrieved August 6, 2010, from http://www. motorola.com/Consumers/US-EN/GLPzh_TW
dc.relation.reference (參考文獻) Natick, Mass. (2010, June 10). Boston Scientific Announces FDA Approval for Latitude® Patient Management System software Upgrade. PCRonline. Retrieved November 12, 2010, from http://www.pcronline.com/News/Press-releases/Bosto n-Scientific-Announces-FDA-Approval-for-LATITUDE-R-Patient-Management-System-Software-Upgrade2zh_TW
dc.relation.reference (參考文獻) OECD. (2006). Projecting OECD health and long-term care expenditure: what are the main drivers? Retrieved November 29, 2010, from http://www.oecd.org/ dataoecd/57/7/36085940.pdfzh_TW
dc.relation.reference (參考文獻) ResMed, Ltd. ResMed. Retrieved August 6, 2010, from http://www.resmed. com/ap/index.htmlzh_TW
dc.relation.reference (參考文獻) Robert Bosch LLC. (2009). Robert Bosch North America, Healthways Announce Availability of Single License for Joint Patent Portfolios. Retrieved Agust 6, 2010, from http://www.healthbuddy.com/content/language1/html/6001_ENU_XHTML. aspxzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration.(2002). General principles of software validation; final guidance for industry and FDA staff. Retrieved March 18, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm085281.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2003). Class II special control guidance document: arrhythmia detector and alarm. Retrieved June 1, 2010, from http:// www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/ucm072671.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2005). Guidance for the content of premarket submissions for software contained in medical devices. Retrieved March 18, 2010, from http://www.fda.gov/downloads/MedicalDevices/DeviceRegulation andGuidance/GuidanceDocuments/UCM089593.pdfzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2009a). Device advice: investigational device exemption (IDE). Retreived March 29, 2010, from http://www.fda.gov/Medical Devices/DeviceRegulationandGuidance/HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/default.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2009b). How to prepare a Special 510(k). Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/Device RegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/ucm134573.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration.(2009c). IDE application. Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/ucm046706.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration.(2009d). IDE approval process. Retrieved March 29, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGui dance/HowtoMarketYourDevice/InvestigationalDeviceExemptionIDE/ucm046164.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration.(2009e). Premarket approval(PMA). Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/default.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration.(2009f). Premarket notification (510k). Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/default.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2009g). Quality systems regulation. Retrieved March 20, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/PostmarketRequirements/QualitySystemsRegulations/default.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2010a). How to market your device. Retrieved March 28, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationand Guidance/HowtoMarketYourDevice/default.htmzh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2010b). Premarket notification [510(k)] Review Fees. Retrieved December 1, 2010, from http://www.fda.gov/MedicalDevices/ DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/ucm134566.htm。zh_TW
dc.relation.reference (參考文獻) U.S. Food and Drug Administration. (2010c). PMA review fees. Retreived December 4, 2010, from http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/ HowtoMarketYourDevice/PremarketSubmissions/PremarketApprovalPMA/ucm048161.htmzh_TW
dc.relation.reference (參考文獻) U.S. National Library of Medicine. ECG: MedlinePlus medical encyclopedia image. Retrieved October 26, 2010, from http://www.nlm.nih.gov/medlineplus/ency/im agepages/1135.htmzh_TW