델파이 조사와 AHP 분석을 활용한 인공지능 기반 SaMD 도입 의사결정 요인에 관한 연구
A Study on the Decision Factors for AI-based SaMD Adoption Using Delphi Surveys and AHP Analysis
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디지털 혁신의 확산에 따라 의료 분야에서도 인공지능을 기반으로 한 혁신의료기술의 채택이 활발해지고 있다. 이에 따라 인공지능 기반 소프트웨어형 의료기기인 SaMD(Software as a Medical Device)의 출시및 도입도 촉진되고 있지만, 의료기관의 SaMD 도입 요인에 대한 연구는 미흡한 편이다. 본 연구의 목적은 ‘인공지능 기반 SaMD’ 도입에 대한 의료기관의 의사결정에 영향을 미치는 중요한 요인들을찾고, 이들 요인의 가중치와 우선순위를 분석하는 것이다. 이를 위해 의료계의 기술수용 모델, 의료 인공지능및 SaMD 등에 관한 문헌연구 결과를 바탕으로 델파이 조사를 실시하였으며, HOTE(Human, Organization, Technology and Environment) 프레임워크와 HABIO(Holistic Approach {Business, Information, Organizational}) 프레임워크를 결합하여 연구 모형을 개발하였다. 5가지 주기준과 22개의 하부기준으로 구성된 연구 모형을 바탕으로 국내 의료기관과 SaMD 공급자의 전문가들을 대상으로 AHP(Analytic Hierarchy Process) 분석을 실시하여 SaMD 도입 요인을 실증적으로 분석하였다. 본 연구의 결과, 인공지능 기반의 SaMD 도입을 결정하는 주기준의 우선순위는 기술적 요인, 경제적 요인, 인적 요인, 조직적 요인, 환경적 요인의 순으로 나타났고, 하부기준의 우선순위는 신뢰성, 진료원가 절감, 의료진의 수용도, 안전성, 최고 경영자의 지원, 보안성, 인허가 및 규제 수준의 순이었다. 특히, 신뢰성, 안전성, 보안성 등의 기술적 요인이 SaMD 도입에 있어서 가장 중요한 것으로 나타났다. 또한, 각 집단별 가중치와 우선순위를 비교ㆍ분석한 결과, SaMD 도입 요인의 가중치와 우선순위는 기관의 유형, 의료기관의 유형 및 의료기관 보직의 유형에 따라 매우 다른 것으로 나타났다.
Abstract
With the diffusion of digital innovation, the adoption of innovative medical technologies based on artificial intelligence is increasing in the medical field. This is driving the launch and adoption of AI-based SaMD(Software as a Medical Device), but there is a lack of research on the factors that influence the adoption of SaMD by medical institutions. The purpose of this study is to identify key factors that influence medical institutions’ decisions to adopt AI-based SaMDs, and to analyze the weights and priorities of these factors. For this purpose, we conducted Delphi surveys based on the results of literature studies on technology acceptance models in healthcare industry, medical AI and SaMD, and developed a research model by combining HOTE(Human, Organization, Technology and Environment) framework and HABIO(Holistic Approach {Business, Information, Organizational}) framework. Based on the research model with 5 main criteria and 22 sub-criteria, we conducted an AHP(Analytical Hierarchy Process) analysis among the experts from domestic medical institutions and SaMD providers to empirically analyze SaMD adoption factors. The results of this study showed that the priority of the main criteria for determining the adoption of AI-based SaMD was in the order of technical factors, economic factors, human factors, organizational factors, and environmental factors. The priority of sub-criteria was in the order of reliability, cost reduction, medical staff’s acceptance, safety, top management’s support, security, and licensing & regulatory levels. Specifically, technical factors such as reliability, safety, and security were found to be the most important factors for SaMD adoption. In addition, the comparisons and analyses of the weights and priorities of each group showed that the weights and priorities of SaMD adoption factors varied by type of institution, type of medical institution, and type of job in the medical institution.
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