影響醫生使用電子病歷的驅力與阻力之研究

The Drivers and Resistance of Doctors Adopted Electronic Medical Record System

翁玉霞(Yu-Hisa Weng)

指導教授 ： 吳坤山

淡江大學/管理學院/企業管理學系碩士在職專班/碩士(2012年)

https://doi.org/10.6846/TKU.2012.01062

摘要

論文名稱：影響醫生使用電子病歷的驅力與阻力之研究 頁數：47
校系(所)組別：淡江大學企業管理學系碩士在職專班
畢業時間及提要別：100學年度第2學期學位論文提要

研究生：翁玉霞 指導教授：吳坤山 博士

論文提要內容：

有鑑於電子病歷(Electronic Medical Record, EMR)具有減少醫療疏失、提升醫療品質、提高醫師的看診效率等優點，世界先進國家皆積極發展中。醫師是使用電子病歷系統最主要且為最關鍵的人物，如同任何一項新科技產品剛發明或剛上市的時候，定有部分消費者願意採用新科技產品，部分消費者則會抗拒使用新科技產品，電子病歷系統的使用對醫生來說也是如此。
然而在紙本病歷數位化的前提下，除了須仰賴資訊技術環境的改善外，醫生在繁重的工作負荷下，尚需不斷學習新的相關技能，及配合電子化尚須接受適當的操作訓練，否則將無法勝任此工作的改變。醫生對這些額外工作上的要求，其接受程度也大不一致，特別是其對電子病歷推動的接受度與行為意向之問題，更是鮮少有研究對其加以探討。緣此，本研究將以國內各醫院包括醫學中心、區域醫院及地區醫院的執業醫師為研究對象，探討醫生使用電子病歷系統的不公平認知、感到威脅性、認知有用性、知覺行為控制、主觀規範與使用意向間之關聯。本研究總計發放122份問卷，因採現場人員發放問卷及同時回收，故回收樣本數為122份，有效樣本回收率為100%。透過敘述性統計、信度分析、效度分析、及結構方程模型(Structural Equation Modeling, SEM)中之偏最小平方估計法(Partial Leat Square, PLS)進行分析，其主要研究結果如下：
1.醫生對電子病歷的認知有用性顯著正向影響行為意向。
2.感到威脅性顯著負向影響醫生使用電子病歷的意願。
3.不公平認知顯著正向醫生對電子病歷的認知威脅性。
4.知覺行為控制顯著正向影響醫生使用電子病歷的意願。
5.主觀規範顯著正向醫生對電子病歷的認知有用性。
關鍵字：電子病歷、感到威脅性、不公平認知、認知有用性、知覺行為控制、主觀規範、使用意向

關鍵字

電子病歷 ； 感到威脅性 ； 不公平認知 ； 認知有用性 ； 知覺行為控制 ； 主觀規範 ； 使用意向

並列摘要

Title of Thesis：
The Drivers and Resistance of Doctors Adopted Electronic Medical Record System Total pages:47
Key word: Electronic Medical Records (EMR), Perceived Threat, Perceived Inequality, Perceived Usefulness, Perceived Behavior Control, Subject Norm, Behavior Intention
Name of Institute: Executive Master’s Program of Business Administration (EMBA) in General Management
Graduate date: June, 2012 Degree conferred : Master
Name of student: Weng, Yu-Hisa Advisor: Wu, Kun-Shan, Ph.D
翁玉霞 吳坤山　博士
Abstract:
In the light of the electronic medical records (EMR) has the advantages of reducing medical negligence, enhancing the quality of healthcare, improving the efficiency of the physician’s inspection service, and so on, advanced countries in the world are actively developing. Physicians are the most important and most critical figures who use electronic medical records system. As with any new technology products have just invented or newly launched, there must be some consumers willing to adopt new technology products, some consumers will be reluctant to use them. The similar phenomenon is also happened to the use of electronic medical records system by physicians.
However under the premise of digitizing paper-based medical records, except for relying on the information technology environment to be improved, doctors with heavy workload still need to keep on learning new skills, and to receive proper operational training to keep up the steps of digitization, would otherwise not be qualified for this change. With regard to these extra requirements, the acceptance of doctors are inconsistent, especially on promoting acceptance of electronic medical records and behavioral intention, but few studies have explored it.
Therefore, with the practicing doctors from domestic hospitals, including medical centers, regional hospitals and district hospitals, as study object, the present research paper investigates the relationships of the use of electronic medical records system by doctors among percived inequality, perceived threat, perceived usefulness, perceived behavioral control, subjective norm, and behavior intention. This study surveyed 122 questionnaires, due to the site personnel put out and took back questionnaires simultaneously, thus recovery of the sample is 122, and the effective sample rate of 100%. Through analyzing of descriptive statistics, reliability analysis, validity analysis, and Partial Least Square (PLS) of Structural Equation Modeling (SEM), the main findings are as follows:
1.Doctors’ perceived usefulness towards EMR is significantly positively associated with their behavior intention.
2.Doctors’ perceived threat towards EMR is significantly negatively associated with their usage intention.
3.Doctors’ perceived inequality towards EMR is significantly positively associated with their perceived threat.
4.The perceived behavioral control is significantly positively is associated with their usage intention of EMR.
5.Subject norm is significantly positively associated with doctors’ perceived usefulness towards EMR.

並列關鍵字

Electronic Medical Records (EMR) ； Perceived Threat ； Perceived Inequality ； Perceived Usefulness ； Perceived Behavior Control ； Subject Norm ； Behavior Intention

參考文獻

4.黃秀麗(2010)。扶輪社會員入住養生村行為意向之研究。淡江大學企業管理學系碩士在職專班碩士論文。

2.李婉怡、趙珮如(2004)。醫療產業員工對電子病歷之科技接受模式探討-以中南部地區為例。醫務管理期刊，5(2)，243-269。

28.Gray, J. L. and Stark, F. A. (1984). Organizational behavior concepts & applications. 3rd edition. Charles E. Merrill Publishing. Co., Columbus, Ohio.

4.Ajzen, I and Driver, B. L.(1992). Application of the theory of planned behavior to leisure choice. Journal of Leisure Research, 24(3), 207-224.

6.Anderson, J. C. and Gerbing, D. W. (1988). Structural equations modeling in practice: A review and recommended two-step approach. Psychological Bulletin, 103, 411-423.