重規劃公部門之整合式話務客服系統－以台灣中央健保署為例

Abstract

近年來台灣的產業逐漸加入了服務導向的概念，並強調服務品質與顧客的滿意度，甚至於公部門又或是非營利機構也開始重視客服中心的建置，其中衛生福利部中央健康保險署（以下簡稱健保署）亦於六大分區（以下稱各分區）設有客服中心。然而健保署的各分區客服中心話務量幾乎超越現有人力的負荷量，無法滿足營運上之需求且效率有待改善。本研究以需求工程及服務設計的觀點，有系統的為健保署規劃了一套整合話務系統、顧客關係管理系統以及商業智慧之「創新智慧服務平台」以改善健保署客服中心營運效率。本研究以實地訪談法進行，前往各分區業務組與各分區主管及客服中心執機人員進行實地訪談與場地會勘，以I.D.E.A.（即洞見（Insight）、設計（Design）、表達（Expression）與評估（Assessment））四個階段，有系統地歸納出健保署客服中心之三大問題，包括：（1）進話線路：目前各分區皆有接聽不及的狀況，然而增加進化線路，勢必也將增加建置成本與座席人力，因此客服中心之線路仍有重新規劃的必要性；（2）客服中心流程：由於各分區客服中心服務流程不盡相同，且對於目前客服系統資料之應用僅限於儲存與調閱，並無法有效對資料進行分析或加值應用，不利管理者決策之制訂；（3）服務人力：目前署內之客服人員每日平均服務民眾數量皆已超出可負荷之業務量，導致該區的客服人力流動率高，新進職員也必需要馬上進入狀況，這中間的訓練轉移成本亦需更審慎之評估。有鑑於上述問題，本研究提出了二項建議方案，並提供對應方案之評估準則衡量指標。擺脫以往認為公部門無需成主客服中心的概念，本研究結合需求工程及服務設計的觀點提出I.D.E.A.四個階段，並詳述每個階段之活動且以健保署為例，提出相關之解決方案，本研究之研究發現能夠做為未來非營利組織在規劃（包含重規劃）客服平台之參考依據。

In the recent years, Taiwan's industries are adding service-oriented concept in their operation and they also emphasize on service quality and satisfaction of customer. There many private and public organizations are starting to focus on the building of customer service center. For example, the National Health Insurance Administration (NHIA) also established customer service centers in its six regions. But each regional center has overload calls that is beyond the loading of existing manpower. These situations cannot satisfy the requirement of operations and the customer service of call center is not very efficiency. Therefore, this research plans an innovative smart service platform (ISSP) to integrate call center, customer relationship management, and business intelligence based on requirement engineering and service design, and We hope ISSP will improve the operational efficiency of NHIA's customer service center. This research adopted face-to-face interview in all of regional centers with NHIA's staff and we also concluded three major issues in the NHIA's call centers that analysis is based on I.D.E.A. (Insight, Design, Expression and Assessment). These issues are (1) operational model: the centers do not have backup mechanism and employees turnover rate is very high because most of them are outsourcing manpower; (2) data consistency: the data formats and data fieldname are not consistency in NHIA, hence the heterogeneous systems are difficult to merge; Finally, NHIA is not to apply data on making decision and it is not propitious for managing. According to the above issues, this research proposes two solutions for NHIA and provides evaluation critical measurements for each solution. This research tries to combine requirement engineering and four stages of I.D.E.A. which is coming from service design, we also illustrate all the actions in each stage within the NHIA and propose related solutions for NHIA. Finally, this research hopes these proposed solutions could be an important guideline for designing the customer service platform of the nonprofit organization in the future.