應用任務－科技適配度於電子病歷繪圖實證研究-以某區域教學醫院為例

Applying Task-Technology Fit on EMR Drawing Tool: A Case Study of a Regional Teaching Hospital

鄭卉嵐(Cheng Hui-Lan)

指導教授 ： 張怡秋

國立中正大學/管理學院/資訊管理學系/碩士(2013年)

摘要

2000年起衛生署致力於推動實施電子病歷，從政策擬定、資訊化基礎建設到電子病歷標準制定，除鼓勵實施也要求醫院能夠跨院互通電子病歷且能與評鑑及健保審查結合，此舉不但加速推動醫療作業資訊化及院際病歷互通整合，也加快院所從實體化病歷到電子化病歷的腳步。
邁入全面電子化同時仍有許多挑戰與瓶頸，目前個案醫院病歷手繪圖已全面電子化，醫師若需繪圖說明，則使用繪圖板或滑鼠操作畫筆功能，在相關底圖上進行描繪與註解或於系統直接繪圖，但醫師認為滑鼠繪圖「不便且緩慢」、「很難操作」、「感應不佳」導致醫師使用意願極低，造成病歷手繪圖記錄與便利的需求難以同時滿足，對於忙碌的臨床工作造成相當大的負荷，而國外的研究亦指出：醫師在使用電子病歷系統時輸入介面不便，是影響醫師採用電子病歷原因之一。因此，本研究提出藉由實證研究以「任務-科技適配度」的觀點，來探討繪圖輸入工具與電子病歷手繪圖對使用程度及績效的課題。
根據研究結果，任務科技適配度正向影響醫師使用資訊科技輔助電子病歷繪圖與其使用績效，使用亦會正向影響使用績效，而病歷繪圖工具目前仍以滑鼠為主，研究結果顯示滑鼠並非優良繪圖工具，因而導致使用電子病歷繪圖對資訊科技依賴程度低，影響其對於使用資訊科技輔助繪圖績效。未來醫療院所導入資訊科技時，能否調查使用者的想法與意願，以使用者角度思考科技導入使用後，對於實際業務上協助是否真能有所助益，而對於醫療資訊系統的規劃與建置時，需考量系統功能性與醫師間的平衡，以求雙贏。

關鍵字

電子病歷 ； 任務科技適配度 ； 電子病歷繪圖

並列摘要

In 2000, the Ministry of Health and Welfare announced its commitment to promoting the implementation of electronic medical records (EMRs). Regarding the development of relevant policy, informatized infrastructure, and EMR standards, the Ministry of Health and Welfare not only encouraged hospitals to fully implement EMRs, but also required that their EMRs possess cross-organizational interoperability and enable relevant assessments and health insurance reviews. This achievement accelerated the informatization of medical operations as well as the interoperability and integration of medical records between institutions. Furthermore, this strategy expedited the transition from paper records to EMRs.
Nevertheless, numerous challenges and bottlenecks to comprehensive digitization remain. Currently, the medical record drawing tools used by the hospitals investigated in this study have been digitized. For physicians who use drawings to explain a diagnosis or condition, they can sketch and annotate on image templates using a drawing board or a mouse, which serves as a stencil. Alternatively, the drawings can be sketched directly into the system. However, several physicians reported that the mouse-sketching method was inconvenient, slow, difficult to use, and offered low sensitivity, resulting in their reduced intention to use this method. For this reason, demands for hand-drawn medical charting tools and convenient documentation are difficult to satisfy simultaneously, which adds a considerable burden to the already significant clinical workload.
International studies have also indicated that the inconvenience of the EMR input interface is among the reasons contributing to physicians’ reluctance to use the system. Therefore, this study proposes the concept of task-technology fit, and through empirical research, investigates the effects that drawing input devices and EMR drawings have on usage and performance.
According to the study results, task-technology fit positively affects physicians’ use of information technology (IT)-aided EMR drawings, which in turn positively influences the drawing performance. The results indicated that because a computer mouse remained the primary EMR drawing tool, the poor performance lead to physicians’ low dependence on IT equipment for producing EMR drawings. Their limited usage subsequently affected the performance of IT-aided drawings.
When introducing IT applications in the future, health care institutions should examine user perceptions and usage intentions, adopting a user perspective to determine whether the technology can benefit physicians during actual operations. In addition, when planning and implementing health information systems, health care institutions must aim to achieve a balance between system functionality and physician demand to create a mutually beneficial situation.

並列關鍵字

Medical Record Drawing Tool ； Electronic Medical Records (EMRs) ； Task-Technology Fit (TTF)

參考文獻

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