AI Healthcare Challenges: The Need for System Design and Governance Beyond Technology Implementation

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At the New National Hospital of Taipei Medical University, the 'CKM Glyco-Renal-Cardio Integrated Care System' was implemented, significantly improving blood sugar control rates for diabetic patients (from less than 50% to nearly 60%). This system provides cross-departmental data integration and risk prediction, enhancing patient motivation by presenting results in an understandable format. However, the article argues that the true challenge lies not in technology but in the institutional framework. Current National Health Insurance coverage is based on 'single disease/single department/single instance,' lacking economic incentives for team care or cross-departmental efforts for patients with multiple chronic diseases. Other issues include supporting new models like 'home hospitalization' and establishing clear accountability (governance) for AI-assisted decisions. The author emphasizes that future progress requires ensuring data interoperability based on FHIR standards and designing cross-departmental reimbursement mechanisms, necessitating evolution through both technology and policy.