人口的老化為醫療系統帶來壓力，醫療機構需要面對服務需求與成本的增加及勞動力不足等挑戰。但醫療機構對於數位科技的採用呈現相對相對保守與落後，再加上因應面對市場競爭，連鎖診所這種後設型醫療機構的出現，使得後設型醫療機構的數位轉型，成為一個值得探索的議題。
後設型醫療機構對成員組織缺乏法定權力，在這樣的情況下如何推動數位轉型的集體行動？本研究採取個案研究的方式，探討後設型醫療機構如何進行數位轉型，同時也探索後設型醫療機構與傳統型醫療機構，在推動數位轉型之過程中有何異同。
研究結果發現，醫療機構的數位轉型，會經歷察覺(awareness)、發展(develop)、推動(promote)等三個階段。因應數位轉型動機不同，會由不同的層級的組織中的成員扮演推動者的角色，同時影響數位方案建置策略。後設組織的醫療機構因其成員組織具有自主權，會透過試用或試點的方式，以證據來說服成員組織接受轉型方案；傳統組織則是由高層決定轉型方案後，促使組織中的成員採用。另外對於轉型過程中的阻礙，兩種不同類型組織的醫療機構也有不同的克服方式，進而產生不同的轉型軌跡：後設型醫療機構的數位轉型過程是實踐的累積；傳統型醫療機構的數位轉型過程是規劃的實踐，其差異主要因為組織所擁有的權力來源不同所造成。
與傳統對於數位轉型需要清楚的議程相比，本研究揭櫫了數位轉型不一定是組織執行規劃的結果，也可能是在沒有轉型議程下，使用數位科技方案解決組織問題行動之累積。

The aging of the population puts pressure on the health care system, and health care institutions need to face the challenges of increasing service demand, cost, and labor shortage. However, the adoption of digital technology by health care institutions is relatively conservative and lagging, coupled with the emergence of healthcare meta-organizations such as chain clinics in response to market competition, making the digital transformation of healthcare meta-organizations a worthy issue to explore. Healthcare meta-organizations lack legal powers over member organizations. How can they promote collective action for digital transformation under such circumstances? This study adopts a case study approach to explore how healthcare meta-organizations carry out digital transformation, and at the same time, explores the similarities and differences between healthcare meta-organizations and traditional healthcare organization in the process of digital transformation.
The results show that digital transformation of healthcare organizations goes through three stages: awareness, develop, and promote. Depending on the motivation for digital transformation, different levels of organizational members play the role of promoters, which also affects the strategy of building digital solutions. Healthcare meta-organizations, whose member organizations have autonomy, use trial or pilot methods to persuade member organizations to accept transformation solutions with evidence; traditional healthcare organizations decide on transformation solutions by top management and then urge organizational members to adopt them. In addition, different types of organizations have different ways of overcoming obstacles in the transformation process, resulting in different transformation promotion: healthcare meta-organizations' digital transformation process is an accumulation of practices; traditional healthcare organizations' digital transformation process is a practice of planning, mainly due to the different sources of power they possess.
Compared with the traditional view that digital transformation requires a clear agenda, this study reveals that digital transformation may not be the result of organizational planning, but rather the accumulation of various actions taken to solve organizational problems using digital technology solutions.

論文審定書 i
致謝 ii
摘要 iii
Abstract iv
目錄 vi
圖目錄 ix
表目錄 x
第一章 緒論 1
1.1 研究背景與動機 1
1.2 研究目的與問題 3
1.3 論文架構 4
第二章 文獻探討 7
2.1 數位轉型 7
2.1.1 數位轉型的定義 7
2.1.2 為何需要數位轉型 9
2.1.3 如何進行數位轉型 10
2.1.4 醫療機構的數位轉型 12
2.2 組織變革 13
2.2.1 變革管理模式 14
2.2.2 組織變革循環 16
2.3 後設組織(Meta-organizations) 20
2.3.1 後設組織的沿革 21
2.3.2 後設組織與傳統組織的差異 23
2.3.3 後設組織的決策 28
2.3.4 後設組織的相關研究 30
2.4 權力 32
2.4.1 Weber的權力與權威 32
2.4.2 French & Raven五種權力基礎 34
2.5 澳洲Princess Alexandra Hospital (PAH)的數位轉型歷程 36
2.5.1 澳洲醫療體系簡介 38
2.5.2 PAH簡介 38
2.5.3 個案背景簡介 39
2.5.4 ieMR系統簡介 41
2.5.5 規劃階段 42
2.5.6 Princess Alexandra Hospital (PAH)的導入階段 42
2.5.7 Princess Alexandra Hospital (PAH)執行團隊的願景 43
2.5.8 臨床人員參與 44
2.5.9導入初期的支持 46
2.5.10 從過渡到持續使用 48
2.5.11 數位轉型的成果與現況 49
第三章、研究方法 52
3.1研究設計 53
3.2個案的選擇 55
3.2.1 抽樣方式 55
3.2.2 研究場域：Abc牙醫聯盟 55
3.2.3 Abc牙醫聯盟是後設型醫療機構 56
3.3資料來源的選擇 58
3.4資料分析 59
3.5研究品質的達成 62
肆、研究個案：Abc牙醫聯盟 64
4.1 Abc牙醫聯盟的成立沿革與合作方式 64
4.2 問題的產生：如何面對Google負評 68
4.3 導入Dr. Right滿意度偵測系統 69
4.4 病歷全面電子化 71
4.5 醫師對病人的評價引發反彈 75
4.6 病人就診後的抱怨 76
4.7 開始電子約診 78
4.8 試用「牙醫管家」 80
4.9 改善「牙醫管家」的加入比例 80
4.10 修改「一鍵取消」功能 83
4.11 全面推廣「牙醫管家」 85
第五章 研究結果 87
5.1 醫療機構數位轉型的歷程 87
5.1.1 察覺（數位轉型的動機與發起） 88
5.1.2 發展（數位轉型方案） 90
5.1.3 推動（轉型的過程） 93
5.1.4 個案數位轉型歷程的差異 102
5.2 個案轉型過程權力應用之比較 105
第六章 結論與意涵 110
6.1 結論 110
6.2 研究貢獻 111
6.3 研究建議 112
6.4 管理意涵 113
6.5 研究限制 114
參考文獻 116
中文 116
英文 116

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