過去COVID-19疫情突顯了遠距醫療(Telemedicine)在醫療服務中的關鍵角色，為確保病患照護不中斷，全球醫療從業人員迅速採用遠距醫療作為應變措施。隨著疫情趨緩，遠距醫療正面臨由「緊急應用」邁向「常態整合」的轉型需求。然而，關於後疫情時代遠距醫療導入醫療體制研究缺乏，且未能全面探討阻礙遠距醫療廣泛採用的挑戰與策略，因此不利於將遠距醫療常規化與制度化，使其可以融入成為現行醫療體系標準的一環。本研究旨在建構一套分析架構，辨識實施障礙，並提出具體的遠距醫療之導入策略。透過文獻回顧與實證資料的綜合分析，深入探討遠距醫療服務從疫情應變過渡至制度化應用的關鍵策略，並從醫療從業人員在疫情下的的實務經驗中觀察萃取，進一步揭示推動遠距醫療導入現行醫療系統並持續發展所面臨之挑戰與障礙。
本研究基於創新阻力理論(Innovation Resistance Theory，IRT)與科技接受與使用統一理論(Unified Theory of Acceptance and Use of Technology，UTAUT)之擴展模型，結合基於臺灣醫療從業人員的專家訪談與調查結果，歸納出影響遠距醫療導入醫療院所的四大障礙構面：使用效益(Usage Benefit)、風險顧慮(Risk Concern)、機構支援(Institutional Support)與社會影響(Social Influence)，並進一步釐清其下共計16項關鍵障礙。本研究進一步採用了混合方法包含詮釋結構模型(Interpretive Structural Modeling，ISM)、重要性-接受度分析模型(Importance-Acceptance Analysis，IAA)、決策試驗與評估實驗室方法(Decision Making and Trial Evaluation Laboratory，DEMATEL)，以及分析網路程序法(Analytic Network Process，ANP)進行系統性的問卷分析，將質性研究轉為量化數據並提出具體可行的發展路徑與短長期因應行動與目標。
研究主要結果顯示，醫療機構與服務提供者在推動遠距醫療的初期，應暫緩處理風險與照護品質相關議題，優先投入於增進系統互通性、服務可近性及政策資源支持之建構。而基於社會條件的相關影響則可於資源允許時逐步改善。本研究提出的策略路徑可為政策制定者和機構提供實用指南，幫助他們重新思考服務發展模式，進一步提高使用者接受度，並促進醫療保健的短期可及性與長期改善。此外，本研究更強調醫療從業人員為推動遠距醫療落實的核心推力，並提出短長期的適應性策略，以強化其參與動機與實務支持。落實本研究建議的相關策略，將有助於促進遠距醫療從臨時應變工具轉化為醫療體系中不可或缺的常規機制，進而提升後疫情時代醫療的可近性、效率與品質。

The COVID-19 pandemic underscored the critical role of Telemedicine in maintaining continuity of care. In response, healthcare practitioners globally, as well as in Taiwan, rapidly adopted Telemedicine solutions. As the pandemic subsides, the focus must now shift from emergency deployment to strategic, sustainable integration of Telemedicine into routine and standard healthcare delivery. However, existing research has not fully examined the multifaceted challenges that hinder its institutionalization.
This study aims to establish a comprehensive framework for the long-term adoption of Telemedicine, identifying key barriers and proposing evidence-based strategies for sustainable implementation. Drawing upon an extensive literature review and empirical data from Taiwanese healthcare practitioners, this research leverages an extended model combining Innovation Resistance Theory (IRT) and the Unified Theory of Acceptance and Use of Technology (UTAUT). Sixteen critical obstacles were identified, categorized across four dimensions: Usage Benefit, Risk Concern, Institutional Support, and Social Influence. Using advanced hybrid methodologies, including Interpretive Structural Modeling (ISM), Importance–Acceptance Analysis (IAA), Decision-Making Trial and Evaluation Laboratory (DEMATEL), and the Analytic Network Process (ANP), the study proposes actionable and prioritized strategies for Telemedicine integration.
Key findings suggest that, in the short term, healthcare institutions should deprioritize concerns related to care quality and risk and instead focus on enhancing interoperability, service accessibility, and institutional support. Social influence factors may be addressed progressively as resources permit. Moreover, the study emphasizes the central role of healthcare practitioners as catalysts for Telemedicine adoption. It outlines tailored, phased strategies to enhance their engagement, both in the short term and over the long term. By implementing the proposed framework and strategies, healthcare systems can successfully transition Telemedicine from a pandemic-driven contingency to a permanent, value-driven component of modern healthcare delivery, ultimately improving accessibility, operational efficiency, and quality of care in the post-pandemic era.

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