Medical Review Committee, Ministry of Health and Welfare
Local Health Authorities
Judicial Authorities
Medical dispute cases require medical expert appraisal to provide judicial authorities with evidentiary support for decision-making. Medical expert appraisal plays a critical role in safeguarding medical justice and protecting patients’ rights. Since October 2020, our hospital has revised its Standard Operating Procedures (SOPs) and introduced an “Case Discussion” stage as part of process innovation. This stage enables appraising physicians to move beyond completing appraisal opinions individually and, instead, to identify and assess disputed issues through structured case discussions. Combined with both internal and external dual-level reviews, this approach has enhanced the fairness and impartiality of medical appraisals. Following the process optimization, the cumulative number of outstanding cases handled by our hospital reached 33 between 2021 and 2024, elevating the hospital to first place nationwide.
The appraising physician completes the case summary within seven days. A “Case Discussion meeting” is then convened by the appraising physician, the reviewing physician, and the Head of the Medical Expert Appraisal Section. The department head provides specialist opinions on the points of contention; the reviewing physician provides medical professional opinions and experience in attending medical review meetings; the head of the medical appraisal team provides legal and medical professional opinions on the points of contention and key points for writing a comprehensive case; the medical record team assists with format revision, administrative coordination, and process control.Following team discussions and clarification of disputed issues, a draft appraisal report is completed. The report is subsequently reviewed by the reviewing physician and external committee members, with revisions made before finalization..
In October 2020, an “External Institution–Commissioned Medical Expert Appraisal Management Procedure” was established as part of the operational workflow. The standard document is subject to review and revision at least once every two years.
From 2021 to 2024, the cumulative number of outstanding cases reached 33, ranking first nationwide.
Case Summary Completeness Rate:92% in 2021, achieving 100% for three consecutive years from 2022 to 2024.
Appraisal Opinion Completeness Rate:92% in 2020, achieving 100% for four consecutive years from 2021 to 2024.
According to the Ministry of Health and Welfare timeliness indicator, medical appraisals are required to be completed within six weeks. From 2020 to 2024, our hospital recorded a 0% overdue response rate for cases exceeding the six-week timeframe.
Rate of Initial Appraisal Reports Requiring Supplementation:
0% for our hospital from 2020 to 2024.
Appraising physicians’ satisfaction with the introduction of the case discussion mechanism reached 91%.
Appraising physicians’ overall satisfaction with the operational workflow reached 88%.
Taiwan’s medical expert appraisal system adopts an institutional appraisal model conducted by public agencies, whereas most countries worldwide primarily adopt an individual expert appraisal model.
“Case Discussion meeting” is recommended for reference and adoption by medical expert appraisal units across healthcare institutions nationwide.
The higher the quality of medical expert appraisal, the greater the accuracy and credibility of judicial judgments. This, in turn, safeguards the professional rights of healthcare personnel and ensures justice for patients, truly fulfilling the original intent of “safeguarding fairness through professional expertise and upholding trust through institutional mechanisms.”
