從使用者的觀點探討醫院PACS的使用與效益：兩階段研究

本研究目的主要是從使用者的觀點，了解影響醫護人員使用PACS的因素，以及PACS對醫院所產生的影響。本研究為一兩階段研究。第一階段採問卷調查的方式，針對系統已正式上線醫院的使用者進行調查，以了解在醫院環境與使用者特性的交互影響下，對醫護人員PACS使用行為的影響。第二階段主要針對兩個採用不同類型PACS（全院式PACS與Mini-PACS）的代表性個案醫院之使用者進行訪談與問卷調查，以深入了解PACS對於醫院醫療服務品質的改善及其對組織的效益。第一階段研究結果指出，醫護人員對於院內PACS發展的了解會影響其對淤系統的依賴程度、其對於PACS所產生之醫療照護服務品質改善的認知、以及系統滿意程度。此外，醫護人員的態度對其系統依賴程度與其對於PACS所產生之醫療照護服務品質改善的認知有顯著的影響。教育訓練的提供會影響使用者系統依賴程度及滿意程度。最後，醫護人員所屬部門使用PACS的風氣是影響系統使用率的重要關鍵因素。第二階段個案研究結果指出，對全院式PACS系統的使用者而言，其產生的影響與效益主要包括片檔管理機制的改善（流程、空間、與保存）、縮減檢查流程、及節省耗材費用。相對於建置Mini-PACS的醫院而言，其產生的效益僅於減少節省耗材費用這項因素。

關鍵字

醫學影像儲傳系統

並列摘要

Based on user perspective, the purposes of this study is attempted to understand the causes and effects of PACS user behavior. The results of this study can be used as basis for hospitals to promote and evaluate PACS. Two phases study was employed. The first phase was focused on the effects of user and environment interaction on user behavior. Questionnaire survey was conducted in middle and large hospitals. The second phase was focus on the effects and benefits of PACS. Two selected cases were included: large scale (hospital wide) PACS: ”A” Hospital and Mini-PACS: ”B” Hospital. Interview and survey was carried out in selected hospitals. Three main findings were proposed and discussed in first phase. First, user understanding of PACS development will affect their dependence on PACS, perceived service quality improvement, and system satisfaction. Additionally, user attitudes will affect their dependence on PACS and perceived service quality improvement. Finally, training programs will affect user dependence and satisfaction. Department atmosphere will affect system utility. Results of second phase indicated that for hospital wide PACS, three main effects was proposed including improve management mechanism (process, space, and storage), refine working process, and cost saving. But, the final one was not found out in Mini-PACS.

並列關鍵字

Picture Archiving and Communication Systems PACS

參考文獻

Agarwal, R.(2000).Framing the Domains of IT Management Projecting the Future... Through the Past.Pinnaflex Education Resources, Inc..

Google Scholar

Bandura, A.(1997).Self-Efficacy: The Exercise of Control..New York:W.H. Freeman..

Google Scholar

Barki, H.,Hartwick, J.(1994).Measuring User Participation, User Involvement, and User Attitude.MJQ Quarterly.18(1),59-82.

Google Scholar

Becker, S. H.,Arenson, R. L.(1994).Costs and Benefits of Picture Archiving and Communication Systems.Journal of the American Medical Informatics Association.1(5),361-371.