以科技持續模式探討個人電子健康紀錄之使用意願-以健康存摺為例

Using TCT to investigate factors affecting personal usage of an PHR app - A case study of "My Health Bank"

江欣蒨(Hsin-Ching, Chiang)

指導教授 ： 李孝屏

中山醫學大學/健康管理學院/醫學資訊學系碩士班/碩士(2017年)

摘要

1995年時，世界衛生組織WHO建議醫療機構對於病患的照顧應該由以往的被動式醫療轉變為主動式預防。自2003年電子病歷的正式推行，為台灣的醫療管理帶來許多便利，隨之發展出的電子健康紀錄及個人電子健康紀錄也讓個人健康管理方式愈加接近理想的主動式預防。由於電子病歷的實施帶來許多資訊安全與個人隱私等問題，大部分研究都以此為探討重點，鮮少以一般民眾的角度去討論人們的使用行為以及對系統的態度。本研究以科技接受模式為基礎，以社會風險和信任為輔，透過科技持續理論模型，望能解釋及預測民眾對個人電子健康紀錄系統的接受程度與持續使用意願，並找到其中關鍵影響因素。
本研究問卷以網路及紙本雙重方式發放，共收回439份有效問卷，並以統計分析軟體SPSS和AMOS驗證模型中各個變數的假設關係及依變數的解釋能力。研究結果發現認知易用性會最大的直接影響民眾對系統的滿意程度以及系統有用程度，並間接地影響民眾的持續使用意願。

關鍵字

PHR ； 科技接受模式 ； 科技持續理論 ； 信任 ； 風險

並列摘要

In 1995, the World Health Organization (WHO) suggested that the medical care on patients should be converted from passive care to active prevention. Since the implementation of electronic medical record (EMR) was officially announced in 2003, it brought enormous convenience to Taiwanese medical management. Along with the development of electronic health records (EHR) and personal e-health records (PHR), it also makes personal health management closer to ideal. Researchers are now looking into the issues caused by the implementation of EMR, including information security and privacy violations. However, discussions have rarely been focused on the behavior and attitude of general citizens toward the PHR system. This study is based on the Technology Acceptance Model (TAM) and used social risk and trust as factors. Through the Technology Continuous Theory (TCT), this study may explain and predict user acceptance as well as continuance intention of the PHR system, and discover the critical impact factors of usage.
A total of 439 valid questionnaires were collected and analyzed by statistical analysis software SPSS and AMOS to validate the relationship between variables and the explanatory ability according to the variables. This study found that perceived ease of use has the greatest direct impact on perceived usefulness and user satisfaction when using PHR, and indirectly affect the public IS continuance intention.

並列關鍵字

PHR ； TAM ； TCT ； Trust ； Risk

參考文獻

Civan, A., Skeels, M. M., Stolyar, A., & Pratt, W. (2006). Personal health information management: consumers' perspectives. AMIA Annu Symp Proc, 156-160.

Health Level Seven® INTERNATIONAL. (1987). Retrieved from http://www.hl7.org/

台灣法務部. (2001). 電子簽章法 第二條.

簡文山, 楊哲銘, 溫信財, 李友專, & 徐建業. (2008). 以Taiwan Electronic Medical Record Template 建構可攜式電子病歷文件之基礎. [Building Taiwan Electronic Medical Record Template for the Basis of Portable EMR Document]. 醫療資訊雜誌, 17(4), 1-10.

Ajzen, I. (1985). From intentions to actions: A theory of planned behavior Action control (pp. 11-39): Springer.