病歷資訊管理室人員保護電子病歷隱私之影響因素探討

An Investigation of the Factors Influencing Medical Records Department Staff to Protect EMRs Privacy

鄭明享(Ming-Shiang Cheng)

指導教授 ： 郭光明

義守大學/醫學院/醫務管理學系/碩士(2015年)

https://doi.org/10.6343/ISU.2015.00211

摘要

背景與目的：隨著資訊科技的進步，病歷由傳統紙本病歷逐步發展為電子病歷。根據行政院衛生福利部統計至民國103年已有321家醫院宣告實施電子病歷，佔全國醫院總家數(492家)65.2%，而通過電子病歷互通應用補助計畫之醫院有297家，佔全國醫院總家數60.4%，且有271家醫院提供電子病歷交換，佔全國醫院總家數55.1%，除醫護人員外，醫院中接觸電子病歷上最頻繁者為病歷資訊管理室員工，故探討病歷資訊管理室人員保護電子病歷隱私影響因素有其必要性。
材料與研究方法：本研究是Rosenstock(1994)之健康信念模式為理論基礎，並配合問卷調查法，使用便利抽樣，以南部地區醫學中心、區域醫院及地區醫院之病歷資訊管理室人員為研究對象進行問卷調查。
結果與結論：本研究共發放231份問卷，回收有效問卷為223份。結構方程模式分析結果顯示自覺行動效益、自覺行動障礙、自我效能與行動線索對於病歷資訊管理室人員保護電子病歷隱私行為意圖具有顯著之影響，表示當醫院增加保護電子病歷隱私系統措施、解決人員行使保護電子病歷隱私之障礙與增加相關資訊課程時，對於保護電子病歷隱私將有所助益。

關鍵字

健康信念模式 ； 電子病歷 ； 隱私保護

並列摘要

Background & Purpose: With the advancement in information technology, electronic medical records (EMRs) have gradually replaced traditional paper-based records. According to the Ministry of Health and Welfare of Executive Yuan, there're 321 hospitals announced that they have implemented EMRs (about 65.2% of Taiwanese hospitals). Furthermore, among them are 297 hospitals passed the financial support program for EMRs interoperability among hospitals (about 60.4% of Taiwanese hospitals). And 271 hospitals can exchange EMRs among hospitals (about 55.1% of Taiwanese hospitals). Besides healthcare professionals, the personnel responsible for the management of patient records have the most opportunity to deal with the EMRs. Therefore, it’s crucial to investigate the salient factors that may influence the protection of EMRs privacy.
Material & Research Method: The research used Rosenstock’s health belief model as the theoretical underpinning and utilized survey methodology. Questionnaires were used to collect data from the staff of the department of health information management (i.e., medical records management department) among medical centers, regional hospitals, and district hospitals in Taiwan via convenience sampling.
Results & Conclusion: A total of 231 questionnaires were distributed and 223 valid questionnaires were collected. The results of Structural Equation Modeling revealed that perceived benefit, perceived barrier, self-efficacy, and cue to action significantly influenced the staff’s intention to protect EMRs privacy. In conclusion, it means that when hospitals improve privacy protection procedures, provide more education programs, and remove the annoying barriers are all beneficial for the protection of EMRs privacy.

並列關鍵字

Health belief model ； Electronic medical records ； Privacy protection

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