醫院病患對隨身電子病歷接受度之分析-以南部某醫學中心為例

The acceptance of the hospital patients toward the portable electronic medical record.-Taking the hospital in the southern region for example.

林佩潔(Pei-Chieh Lin)

指導教授 ： 辛炳隆

共同指導教授 ： 簡文山(Wen-Shan Jian)

國立臺灣大學/社會科學院/國家發展研究所/碩士(2008年)

https://doi.org/10.6342/NTU.2008.01874

摘要

隨身電子病歷是電子病歷發展的創新階段，屬於美國電子病歷協會定義的電子病患紀錄及電子健康紀錄的結合，強調跨出個別醫院藩籬，以病人為中心流通的病歷資訊架構，並期許建構一個包含完整健康醫療資訊的電子病歷，將病歷的所有權回歸病患手中，藉由病人的共同參與，讓他們成為整體醫療團隊的一員，掌握自己的健康，落實預防勝於治療的健康概念。本文是以科技接受模型(Technology Acceptance Model)為基礎，探討不同背景變項的醫院病患對隨身電子病歷的有用性、易用性認知及隱私性、安全性的資訊安全認知程度的高低對其接受度是否有正面影響；並綜合以上分析結果，提供建議予國家，作為政府推行的成效依據與加強宣導層面的參考。
本研究以南部地區某一醫學中心的醫院病患作為主要的研究對象，以問卷調查的方式進行。問卷發放地點依醫院2007年看診比率分配，並分上午看診時段及下午看診時段來取樣，共計有效問卷289份。問卷發放前已先由四位該領域專家審查，通過專家效度在適當性及重要性問題檢測並做過Cronbach’s Alpha的信度檢測，達到的內部一致性相當高。並根據研究假設所提出的研究問題作複迴歸分析與線性重合檢測。本文所欲揭櫫的問卷分析實證結果，驗證了病患在用藥安全及資訊安全風險的認知程度越高對隨身電子病歷的接受度越高；反之，便利使用與健康管理認知程度高低與否並不直接影響其接受度，推論其原因則在於南部地區的民眾對健康管理的觀念普遍不足，且認為兩者與切身安全性較無關，所以不影響其接受程度。政府在推動隨身電子病歷政策時，可依此加強對南區地區民眾做隨身電子病歷在用藥安全及資訊安全功能認知上的宣導，增加其信心並從日常生活中強化其預防勝於治療的觀念。

關鍵字

隨身電子病歷 ； 便利使用 ； 健康管理 ； 用藥安全 ； 資訊安全 ； 接受度

並列摘要

Background: The portable electronic medical record ,a snapshot of the medical record at a specific point in time and the innovative stage of development of the electronic medical record, which focuses on the patients and emphasizes exchanging the information interoperability infrastructure among different hospitals , is the combination of Electronic patient record and Electronic health record defined by Medical Record Institute. The government expected to build the medical record with the complete medical information and devoted to give back the ownership of the medical record to the patient by the participation of them. Thus, the way is to make patients as the member of the medical group to control their own health spontaneously and to implement the concept of that said prevention is better than therapy.
Objective: The study is based on the theory of Technology Acceptance Model which posits that an individual perceives the usefulness and ease of use of the technology, the more positive of the intention to use the technology, the higher intensity in their acceptance. The objective of the study is to understand whether the acceptance of the hospital patients with the different characters influenced by the intensity of perceiving the usefulness , ease of use and the safety of informatics of the portable electronic health record. In the end, in the hope of the study could provide the research suggestion to the government to strengthen the positive effects in this area.
Methods: The proposed model was empirically tested using data collected from a survey in the hospital environment of the southern region in Taiwan. According to the ratio of different medical departments to allocate the samples of the patients to accept the questionnaire. Before the informal testing, the questionnaire has passed the examination of four experts in appropriateness and significance and the Reliability analysis in Cronbach’s Alpha. Afterwards, according to the questions of this research summit the hypothesis testing by regression and multicollinearity.
Results: The result of the questionnaire verifies the acceptance of the portable electronic health record influenced by the perception of the drug safety and the informatics safety, however, the perception of ease of use and health management didn’t influence the acceptance to infer the reason is that people in southern region lack of the health management and perceived that those are unconcerned with the personal concern safety.
Conclusion：The best way to go through with the policy of the portable electronic health record efficiently is to impose the functions of the drug safety and the informatics safety embodied in the portable electronic health record and enhances the confidence in using it. Nevertheless, the basic rule is to lead the concept of Preventive Medicine.

並列關鍵字

The portable electronic health record ； Technology Acceptance Model ； ease to use ； health management ； drug safety ； the informatics safety ； acceptance

參考文獻

7. 石崇良等，2007，〈病人安全對醫療照護者與病人關係之影響〉，台灣醫學，第11卷第6期，頁668-673。

10. 行政院衛生署，2005，〈行政院衛生署推廣電子病歷執行概況〉。

26. 財團法人醫院評鑑暨醫療品質策進會，2006年，「新制醫院評鑑(醫學中心)相關資料｣，web: http://www.tjcha.org.tw/。

32. 陳秀雯，2003，〈電子病歷資訊共享效益分析之研究〉，中原大學工業工程研究所碩士論文。

35. 彭昭揚,蘇俊嘉,許佑任，2005，〈探討醫院病患對健保IC卡使用情形與看法〉，台灣家醫誌，第15卷第3期，頁135-155。