美、台、中電子病歷評價體系之比較研究

A Comparative Study on the Evaluation System of Implementing Electronic Medical Records among Those of the United States, Taiwan and China

陳正美(Cheng-Mei Chen) ； 徐建業(Chien-Yeh Hsu)

《病歷資訊管理》 11卷2期 (2013/02) Pp. 40-53

摘要

隨著各國積極推動實施電子病歷，評價電子病歷應用水準的體系亦逐漸展開。本文以系統性文獻回顧方式，比較分析美國醫療資訊暨管理系統協會（Healthcare Information and Management Systems Society; HIMSS）電子病歷採行模型（Electronic Medical Record Adoption Model; EMRAM）、電子病歷有意義使用（Meaningful Use of Electronic Medical Record）、我國電子病歷查驗與中國大陸電子病歷評價標準等評價體系，作為國內電子病歷評鑑之可行性參考。研究結果顯示，這些評價體系主要差異在於國情、資訊化程度及發展目標的不同。HIMSS EMRAM評估電子病歷應用等級進行市場分析比較；美國電子病歷有意義使用以臨床應用為主；我國電子病歷查驗，著重資訊安全及跨院互通；中國大陸電子病歷評價標準重心仍在醫療紀錄電子化。建議成立專職機構持續推動HIMSS EMRAM作為電子病歷的評價方法，政府每年補助應用等級高的醫院（第6級以上），各醫療機構亦應提早準備通過第六級（stage6）的評價。

關鍵字

電子病歷評價 ； HIMSS EMRAM ； Meaningful Use ； 電子病歷檢查 ； 中國大陸電子病歷評價標準

並列摘要

With the development and implementation of Electronic Medical Records (EMRs) in different countries, the evaluation systems of the EMRs is also expanded gradually. In this study we used schematically literature review to analyze EMRs evaluation systems, such as the EMR Adoption Model (EMRAM) of American Health Information and Management Systems Society (HIMSS), Meaningful Use of Electronic Medical Record, Taiwan EMR audit program, China EHR evaluation standard, and studied the feasibility of adopting EMRAM as an evaluation method in Taiwan. The result shows that the main differences among these evaluation systems are the difference in local cultures, the infrastructure of information technology, and their respective development goals. The EMRAM of HIMSS's main objective is to evaluate an EMR application level and produce valuable market analysis report; Meaningful Use regulation bases on clinical workflow tasks; Taiwan EMR audit program focuses on information security and interoperability; and China EHR evaluation standard specializes on the computerized medical records systems in hospitals. Our recommendation is to set up a full-time institution and continue to promote the EMRAM of HIMSS. The government should subsidies those hospitals rated higher than the level 6 as a encouragement and reward, and that all medical institutions should prepare for being evaluated by suitable evaluation system.

並列關鍵字

EMR evaluation system ； EMRAM of HIMSS ； Meaningful Use ； Taiwan EMR audit program ； China EHR evaluation standard