影響臨床醫師「行動醫療」接受度與使用意願之因素

近年來因科技進步，隨著PDA、平板電腦等行動裝置的出現，發展出醫生攜帶平板電腦或智慧型手機作為巡房時的資訊輔助設備，而運用行動裝置特性，隨時連線查閱病人的電子病歷、向病人解說病情，不但縮短醫師照護病人的距離，也可隨時隨地掌握病人病況，提升醫療品質及病人安全。本研究以DeLone & McLean模式資訊系統成功模式為主軸，建構「行動醫療資訊系統」的評估模式，探討使用者對「行動醫療資訊系統」的關鍵影響滿意度之要素，並暸解臨床醫師的滿意度、使用意願及個人效益間的相關性，進而提出改善方向與建議。本研究為橫斷式問卷調查研究，研究對象為北區某區域教學醫院使用「行動醫療資訊系統」之臨床醫師，共發放120份問卷，回收87份問卷，有效問卷75份，有效回收率為63%。結果發現，在系統功能品質中可靠性(Reliability) （β=0.322 *,t=2.384) 及任務急迫性(Task urgency) （β=0.185 *,t=2.504）；系統資訊品質中資訊準確性(Accuracy) （β=0.347 *,t=2.232）；系統服務品質中服務同理心(Empathy) （β=0.324 **,t=2.715）及服務可靠性(Reliability) （β=0.503 ***,t=3.774）對醫師使用「行動醫療資訊系統」滿意度有顯著的正向影響。而「使用者滿意度」會正向的影響醫師使用行動醫療資訊系統的「使用意願」（β=0.326 ***,t=7.046），且「使用者滿意度」亦正向的影響醫師使用行動醫療資訊系統的「個人效益」「（β=0.141 ***,t=4.012）；最後，「使用意願」會正向的影響醫師使用行動醫療資訊系統的「個人效益」（0.863 ***,t=21.461）。行動醫療資訊系統之成功除醫院經營者須投入金錢、人力及物力推動外，應設計出符合系統之功能品質、資訊品質及服務品質的行動醫療資訊系統，讓使用者滿意因而產生使用意願，且樂於採用，進而成功達到「個人效益」之目標。因此在行動醫療資訊系統推動過程中，醫院部門應定期進行滿意度調查，作為系統改善之參考依據，俾能使行動醫療資訊系統更臻完善。

關鍵字

行動醫療資訊系統；滿意度；使用意願；個人效益

並列摘要

Due to the advance of science and technology, especially the emerging of mobile devices like PDA, tablet, etc. clinicians can use them as auxiliary equipments to look up patients’ clinical information at any time and explain to patients during ward rounds. Thus, mobile devices not only shorten the distance of medical care between clinicians and patients, but also help clinicians have real-time patient’s conditions at anywhere in order to improve the healthcare quality and patient safety. This study is based on “The DeLone and McLean’s Model of Information Systems Success” to build upnd evaluate our “Mobile Health Information System”(mHealth) model. We investigated factors which crucially affect users’ satisfaction with mHealth, the relationship between satisfaction, usage intention, and personal benefit of clinician, then proposed suggestions. Our study was a cross-sectional research, and the objects were clinicians from a northern regional teaching hospital . We distributed 120 questionnaires, 87 responded and 75 were valid, the response rate is 63 %. The results of this study first showed that those factors, Reliability of system function quality (β=0.322 *,t=2.384), Task urgency (β=0.185 *,t=2.504), Accuracy of system function quality (β=0.347 *,t=2.232), Empathy of system function quality (β=0.324 **,t=2.715) and Reliability (β=0.503 ***,t=3.774), had significantly positive effect on clinicians’ satisfaction with “mHealth”. Second, the user satisfaction had positive effect on usage intention of “mHealth”, and also had positive effect on personal benefit of using “mHealth”, (β=0.141 ***, t=4.012). Finally, the usage intention had positive effect on personal benefit of using “mHealth”, (0.863 ***, t=21.461). To make mHealth successful, we not only need hospitals to invest money, manpower, and material resources, but also need to design a useful mHealth which accords with function quality, information quality, and service quality, can satisfy the users’ need, and then make users achieve personal benefit when using it. Therefore, the satisfaction of mHealth should be evaluated regularly to enhance thequality of system.