- 學位論文
探討影響藥師使用健保雲端藥歷系統之關鍵因素
Exploring Critical Factors Influencing Pharmacists using PharmaCloud System
摘要
衛生福利部中央健康保險署在民國102年7月提出健保雲端藥歷查詢系統，健保雲端藥歷提供特約醫事服務機構醫師於臨床處置、開立處方，及藥師用藥諮詢時可即時查詢病人過去 3 個月的用藥紀錄，讓醫師可以更快速的了解病人的用藥資訊及進行醫療決策，或可透過病人簽署同意書，先行下載病人資料，及早評估病人用藥，以避免重複用藥的危險性，讓民眾在用藥上更有安全性，也可以降低醫療的成本。 本研究修正資訊系統成功模式(IS success model)探討影響使用者滿意度的關鍵因素，採用問卷調查法，合併便利性取樣和滾雪球方式(Snow ball sampling)，以具有使用健保雲端藥歷系統經驗的藥師為研究對象，對不同醫事機構層級的藥師進行調查，回收有效樣本共75份。經由統計分析進行假說驗證，本研究採用SPSS及smartPLS為統計分析軟體。 本研究結果顯示，對使用者滿意度之影響為服務品質大於系統品質大於資訊品質，使用者滿意度對績效、生產力、溝通品質之影響為生產力大於績效大於溝通品質，年齡為年輕族群居多21~30歲(52%)，可接受的雲端藥歷系統執行反應時間1~3秒居多(44%)，可見對目前雲端藥歷資訊顯示速度尚未達到預期，並探討各政策配套於實務面之執行情況。 期望本研究之成果，能作為中央衛生主管機關、各醫療資訊業對健保雲端藥歷執行與管理策略之參考，並增益學術界對健保雲端藥歷之成功與持續使用衡量之相關研究，減少病人重複用藥的狀況，提升病人用藥安全，並可確保病人用藥品質。
並列摘要
The Ministry of Health and Welfare Department's Central Health Insurance in the Republic of China proposed NHI PharmaCloud System in July 2014. The purpose of NHI PharmaCloud is to provide special medical services to physicians for clinical management, prescribing, and pharmacist drug counseling by providing immediate query of patients’ medication records over the past three months. The physicians can understand drug information of patients and medical decision-making more quickly and promptly in order to avoid duplication dangerous drugs. Thus making patients safer medication, and reducing the cost of care at the same time. The present study modified the IS success model to explore critical factors influencing user satisfaction on medication safety. Questionnaires were collected by convenient sampling and snow ball sampling from the pharmacists that used NHI PharmaCloud System in various hospitals, clinicians, and community drug stores. 75 valid questionnaires were returned. Statistical analyses including SPSS and smartPLS were used to test the hypotheses proposed in the study. The results showed that the impact on "User satisfaction" with the "Service quality" is greater than the "System quality" is greater than the "Information quality". "User satisfaction" impact on "Care quality" and "Productivity"and"Communication quality", performance, productivity, affecting the "Care quality" is greater than the "Productivity" is greater than the "Communication quality", mostly younger age is 21 ~ 30 years old (52%), acceptable NHI PharmaCloud System to perform the reaction time is 1 to 3 seconds(44%), showing that the current NHI PharmaCloud System display speed has not reached expectations. Meanwhile, the public discussion on various reports also found that the policy supports and improvements also impact on users’ acceptance on NHI PharmaCloud system. The results of this study can be used as the reference by central health authorities, hospitals and medical information industry to the health-care drug reference, Drive Executive and Management Strategies, and gain the academic success of health insurance Cloud medication history of research and sustainable use of the measure, may help to reduce redundant prescriptions, to improve drug safety and to ensure the quality the pharmaceutical care provided.