各國電子病歷趨勢分析及台灣電子病歷發展之研究

Trend Analysis and Future Development of Taiwan Electronic Medical Records

柯琬淇(Wan-Chi Ke)

指導教授 ： 邱泓文

臺北醫學大學/醫學科技學院/醫學資訊研究所/碩士(2013年)

https://doi.org/10.6831/TMU.2013.00068

摘要

各國電子病歷發展越來越成熟，近幾年台灣在電子病歷發展上也有長遠的進步，2011年有23%醫院實施醫療影像及報告、血液檢驗、門診用藥紀錄或出院病歷摘要的四個單張電子病歷，到2012年進行電子病歷的亙通格式與代碼，2013年成立電子病歷專案辦公室，衛生署提出2016年底之前，希望將醫院及診所全面納入電子病歷交換。未來全台民眾在任何地方都能獲得妥善的醫療照顧。

本研究的目的是先透過了解各國電子病歷的文獻來了解各國的趨勢發展及特點，來了解台灣人民對電子病歷的看法及需求，提供醫療機構及政府單位決策者對台灣電子病歷未來發展的一個建議需求。這項研究發現多逹7成的受訪者贊成在台灣電子病歷上增加的項目: (1)有意義的使用 (2)標準緊急應變處理流理 (3)電子病歷存入健保IC卡(4)IC卡存放檢驗、檢查、醫療影像及用藥處理 (5)加註病人敏感性資料欄位 (6)編碼使用ICD-10 (7)由中央提供電子病歷技術解決方案 (8)使用國際標準HL7 (9)未來朝用法律強制醫院製作電子病歷 (10)規範出電子病歷的必需、推薦和可選功能 (11)電子病歷雲端儲存 (12)在PC以外的平台查閱電子病歷資料 。

現行政府對電子病歷的政策和本研究發現有幾項相符，顯示台灣在電子病歷推動上的進步及未來的發展空間。建議未來在推動電子病歷上，要針對醫院人員探究阻力原因，將可以使電子病歷的推動更加快速及完善。

關鍵字

電子病歷

並列摘要

The aim of this study was to validate a specially designed future development of Taiwan electronic medical records (EMRs) questionnaire to be administered by Information officers, non-IT staff and people. This study used PubMed search tools. Paper reviews are about national trends and characteristics of EMRs from the Americas, Oceania, Europe and Asia. To provide EMRs strategies is for future EMRs’ development in Taiwan.

An online questionnaire by using a Google document as a tool in this study, collecting the characteristics of electronic medical records in seven countries, the questionnaire targeted medical institutions, government health units, manufacturers, academic institutions and the public. In order to provide the most appropriate suggestion in Taiwan’s EMR development selected Likert scale. The purpose of this article demonstrated trend analysis of several national electronic medical records and identified the construct validity and reliability of this instrument, based on quantitative research approach. Based on the results of this research provided the needed top three suggestions.
The compilation of the items was presented to the first participants of 2011/10 and the end of 2011/12.Two hundred and sixty four participants answered questionnaire, the average age being 30.

In 2012, the Taiwan Department of Health's electronic medical records only interactive communication format and code plan. In 2016, Department of Health will promote Taiwan’s hospitals and clinic exchanging EMRs. From the above-mentioned questionnaire are questions for asking Taiwanese’s opinion about EMRs in the future. Based on the results of this research provided the needed top three suggestions. 1. Taiwan's EMR need meaningful use as the United States’ EMR. 2. Taiwan’s EMR need SOAP for disaster response. 3. Taiwan needs a governmental EMR office for providing new technique and update.

Based on the result of web surveys with multiple choice and agreement scales; conducting by questionnaire analysis, this study provided the following points. The points provided EMRs’ implementation process in other countries, provided Taiwanese overviews of electronic medical records, analyzed Taiwanese people's views of other countries’ EMRs and provided decision-makers about EMRs’ direction in the future. However, difficulties are expected to be possible bias, the study needs to be examined in expanded people in Taiwan.

並列關鍵字

Electronic Medical Records (EMRs)

參考文獻

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