People in Taiwan rely overwhelmed heavily on medical services due to cultural influences and experiences. On top of that, low healthcare costs, 99.9% coverage offered by National Health Insurance and gradually aging society have all contributed to the phenomena of hospital shopping and polypharmacy.
But things started to change in July 2013. National Health Insurance Agency has launched Pharmacloud, a cloud-based prescription records system. Physicians and pharmacists in different hospitals or clinics can therefore check patients’ previous medication records to avoid repeated medication and drug interaction.
Combination of Medical Care and Technology is a Beacon in Polypharmacy
Again in July 2016, National Health Insurance Agency has released “My Health Bank” service. Besides being able to look up medication and healthcare records, users can view these information on the go. Users’ previous medication records can be shown to physicians and pharmacists in different hospitals or clinics, so that resource waste can be avoided, and so does time spent with the doctors can be shortened. Moreover, with the helps from evidence-based medicine and big data, people can be equipped with health alarm mechanism and public health information, leading people to develop healthier behaviors.
Furthermore, the service has trained medical service providers to conduct safety medication and rational administration through a series of trials. After Pharmacloud was implemented in 2013, such collaboration between National Health Insurance Agency and medical institutions as well as regulatory mechanism have saved USD 330 million in national health insurance costs every year. Take another example from the reimbursement for pharmaceutical care conducted in 2010-2017, national health insurance costs can be saved above 30% if the care is intensively provided by skillful pharmacists to patients with greater difficulties.
How Taiwan Faces the Rapid Aging Challenges is Valuable to the World
Taiwan is facing the challenges of a rapidly aging population. We become an aging society in 1993 and an aged society in 2018. It is also estimated that we will step into a super aged society in 2026. Under such condition, the issues of long-term care and inappropriate medication among the elders then grasp extra attention. Lucky enough, organizations like Taiwan Association of Gerontology and Geriatrics, Taiwan Association of Family Medicine and Taiwan Pharmacist Association have attended the issues between aging and drugs before 2000, and criteria for them have been developed thereafter since 2003.
Since 2009, hospitalist ward has been established in many hospitals to integrate different systems and provide multifaceted medical care services. Taiwan Association of Hospital Medicine, established in 2018, aims at training more hospitalists as a stepping stone to medical care rationalization and integration. On the other hand, Taiwan Society of Home Health Care was established in 2017 by a group of doctors, professional nurses, pharmacists and other specialists who intent on home care services. In responding to the Integrated Home Medical Care Plan, they expect to provide quality and cross professional home care services for Taiwan public. The common characteristic in these two services is that they integrate the medication in hospitals and homes.
Taiwan medical professionals need to accommodate themselves to new challenges and propose solutions to them. Whether they focus in academic, critical care, community medicine or home care, full trained medical professionals are developing various care services. These services will be gradually imported to other aged countries, and learning from each other can therefore be expected.
參考文獻：
- Chiang-Hanisko, L., Tan, J. Y., & Chiang, L. C. (2014). Polypharmacy issues in older adults. The Journal of Nursing, 61(3), 97－
- https://www1.nhi.gov.tw/Nhi_E-LibraryPubWeb/PharmaCloud/PharmaCloud.aspx?FType=11
- https://www1.nhi.gov.tw/Nhi_E-LibraryPubWeb/HealthBank/HealthBank.aspx?FType=9
- https://tw.appledaily.com/new/realtime/20160226/803950/
- http://hpcare.taiwan-pharma.org.tw/
- https://www.ndc.gov.tw/Content_List.aspx?n=695E69E28C6AC7F3
- H. Huang, F.H. Lu. (2003) Prescription Principles in the Elderly. Formosan J Med,7(3), 385-395.
- https://www.tahmed.org.tw/
