基層醫師醫療資訊系統垂直性整合之態度與效益認知探討─以台北市立聯合醫院為例

The Study on Attitude and Benefits

邱昱程(ch'iu yü ch'êng)

指導教授 ： 楊漢湶

亞洲大學/健康學院/健康管理研究所/碩士(2007年)

摘要

醫療資訊系統的整合與分享，避免了重複性的檢驗、減少不必要的醫療資源浪費，同時醫護人員也可得到更完整的資訊，針對病人的病情做出正確的診斷及適當的處置，提高醫療品質。台北市立聯合醫院自94 年開始實施「台北市立聯合醫院與基層診所醫師共享醫療資
訊計畫」，計畫目的為配合健保轉診制度政策、鼓勵醫療資源共享及避免患者重複檢查之困擾，擬開放有合約關係之開業醫師資訊連線，以達資源平台分享及提昇台北市病患之醫療服務品質與就醫可近性。
本研究之目的為了解參與此計畫之基層診所醫師（系統使用者）對於此計畫所抱持之態度及實際帶來之效益認知，並且以基層診所醫師的角度來探討此計畫目的達成之程度，並且找出系統不良之處，而提供改善之方向，期望給予未來其他醫療院所推行類似此計畫之建議
及參考。本研究方法採質性研究，針對參與此計畫之基層診所合約醫師進行深度訪談，訪談個案數為9 位醫師。
本研究之研究結果：1、在醫師的態度方面，醫師認為此計畫的優點為，（1）民眾面：增加就醫便利性及提昇醫療品質；（2）診所面：增加看診之便利性及醫院與診所互動關係；（3）醫院面：增加民眾對醫院的信心；缺點為：在於病患資料保密之安全性。2、在醫師效益認知方面，增加診所門診量、增加民眾對基層醫師的信任、增加民眾對診所的滿意度、避免因轉診而流失病人。3、在系統功能及缺點，多數醫師認為應該將系統上臨床資訊的數位化達到百分之百，而在系統缺點方面，主要為連線品質不佳及操作麻煩。

關鍵字

醫療資訊系統、垂直整合、效益認知、質性研究

並列摘要

Medical Information Sharing and Integration can prevent repeating lab tests and reduce wasting medical resources. Besides, it also provides comprehensive information to healthcare professionals regarding patients’history helping them to make accurate diagnosis and offer proper treatment to patients as well. Since 2005, Taipei City Hospital started the project named, Medical Information Sharing Plan of Hospitals and Clinics (MISPHC). The project is to collaborate with Public Health Referral Policy and to encourage medical information sharing in order to avoid repeating lab tests of the same patient in different hospital. The project also allows contract-clinics to assess medical information in Taipei City Hospital to improve healthcare qualities in Taipei.
There are two purposes of this study; one is to understand clinic physicians’ attitude and benefit cognitions toward MISPH. The other purpose is to understand the achievements and the drawback of the MISPH from physicians’ point of views in order to improve the project for further wide-range promotion. The study method used an in-depth interview with nine clinic physicians and it has the results as the three points followed:
1. The physicians believe MISPH has benefits in three ways –firstly, it profits the public by increasing the healthcare qualities. Secondly, the benefit to the clinic is to stimulate the interaction between clinics and hospitals. Finally, the advantage to the hospitals is to boost the public confident toward hospital. However, there is a shortcoming the physicians concern and it is the security of patient confidentialities.
2. The interviewees mentioned the increase of patient numbers, the trust of the public toward physicians and avoid patient lost during
transferring are the benefit cognitions they have toward MISPH.
3. As to the functions and the drawbacks of MISPH, the physicians agree that the medical information should be a hundred percent digitalized and shared among hospitals and clinics; yet the instabilities and complications of the information system maybe the only drawbacks.

並列關鍵字

Medical Information System；Virtual Integrated；Benefit

參考文獻

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