醫院使用行動醫療影像儲存與傳輸系統（PACS）之研究:任務科技配適的觀點

現今醫療環境中影像儲存與傳輸系統(PACS)已經得到了廣泛的應用，成為醫療機構的主要系統之一。近年來隨著行動網路和行動裝置顯示器解析度的發展，使得行動PACS可有效應用在臨床作業上。2018年利用電腦斷層血管造影(CTA)進行的相關研究表明，PACS工作站和智慧手機的診斷準確率均為100%，這為原有資訊系統中部分功能延伸到移動設備上帶來了可能性。本研究環境以台灣中部地區某醫療集團共有兩間區域教學醫院為研究對象，在已經將採用醫療影像行動化系統後的維運時期使否有需要採取的改善措施，讓系統的任務科技適配程度提高。首先透過半結構式訪談整理出三個在維運時期仍然會影響任務科技適配(Task-Technology Fit, TTF)的因素，除了原本TTF中的『教育訓練』外，還另外發現『內部系統整合』和『基礎設施』會影響維運時期的TTF。之後結合任務科技適配模式與資訊系統成功模式提出研究架構，然後使用問卷調查法做更深入研究，共蒐集醫療、護理人員樣本數共402份，使用Smart-PLS分析，結果發現『內部系統整合』為對於任務科技適配、持續使用意圖、使用者滿意度以及績效影響都是最大，其他影響強度依序則是『基礎設施』與『教育訓練』，研究結果在實務上對於行動化系統的營運策略提供參考，尤其是醫療產業。學術上則對於行動化系統於維運時期提升適配程度的重要因素提供了未來研究參考依據。

關鍵字

影像儲存與傳輸系統；行動化；教育訓練；內部系統整合；基礎設施

並列摘要

Picture archiving and communication system (PACS) are widely used in today's healthcare environment and have become one of the major systems in healthcare organizations. In recent years, with the development of mobile networks and mobile device display resolutions, mobile PACS can be effectively applied to clinical operations. a related study conducted in 2018 using computed tomography angiography (CTA) showed that the diagnostic accuracy of both PACS workstations and smartphones was 100%, which brings the possibility of extending some functions of the original information system to mobile devices. In this study, two regional teaching hospitals of a medical group in central Taiwan were used as subjects to determine if there were any improvements that needed to be made during the maintenance period after the adoption of the medical imaging mobile system to improve the system's task technology adaptation. The first three factors that still affect the Task-Technology Fit (TTF) during the maintenance period were identified through semi-structured interviews, and in addition to the original TTF of "Training", "Internal System Integration" and "Infrastructure" were found to affect the TTF during the maintenance period. A total of 402 samples of medical and nursing staff were collected and analyzed using Smart-PLS. The results showed that "Internal System Integration" had the greatest impact on mission technology adaptation, continuous use intention, user satisfaction, and performance, while the other influences were "Infrastructure" and "Training". The results of the study provide a practical reference for the operation strategy of mobile systems, especially in the medical industry. The results of the study provide a practical reference for the operation strategy of the mobile system, especially for the medical industry. The academic results also provide a reference for future research on the important factors for the mobile system to improve the degree of adaptation during the maintenance period.