探討影響醫師接受與抑制電子化病歷使用意圖之研究

A Study on the Enablers and Inhibitors to Physician's Electronic Medical Record Usage Intentions

黃韻潔(Huang, Yun Chieh)

指導教授 ： 黃維民

國立中正大學/管理學院/資訊管理系醫療資訊管理研究所/碩士(2013年)

摘要

醫療機構之病歷電子化不僅解決了紙本手寫病歷的缺失，也帶來許多潛在效益，然而近年來各國電子病歷的推行速度卻遲滯不前。國內關於電子病歷實施困境的研究，大多以政府或醫院觀點，針對法規政策、技術能力加以探討，但導入電子化病歷不僅有外在環境與資訊技術層面的問題，仍須考慮到組織內部的影響因素。
本研究合併資訊系統的抑制因素於科技接受模式，將「知覺有用性」作為促進因素，「醫師抗拒改變」、「知覺威脅」與「知覺風險」作為抑制因素，探討影響醫師使用電子化病歷系統意圖的接受與抑制因素，其中「知覺風險」以心理風險、安全與隱私風險、時間風險以及績效風險四個變數來衡量。本研究以三家醫學中心和兩家區域醫院之醫師為研究樣本，共發出250份問卷，有效回收問卷為138份。研究結果顯示，在四個知覺風險層面中，醫師較擔心電子化病歷在安全與隱私以及績效上之風險。而電子化病歷使用意圖會受到知覺風險、醫師抗拒改變之負向影響，但知覺威脅對電子化病歷使用意圖並不會造成顯著影響。

關鍵字

知覺風險 ； 知覺威脅 ； 電子化病歷 ； 抗拒改變

並列摘要

The electronic medical records in the healthcare facilities can not only solve the defects of paper-based patient records but also bring some potential benefits to physicians and hospitals. However, the implement of electronic medical records is in a slow progress. Prior research on electronic medical records implementation had largely focus on the view of government or hospitals. We should consider factors within the organization besides the external environment and information technology when introducing electronic medical records into a hospital.
This study integrates inhibitors of information systems into technology acceptance model, and proposes a theoretical model which contains enabler, such as perceived usefulness, as well as inhibitors, such as resistance to change, perceived threat and perceived risk, to understand the antecedent factors of physician's electronic medical record usage intentions. One of the constructs, perceived risk, is composed of four variables, namely psychological risk, security and privacy risk, time risk and performance risk. 138 valid questionnaires out of 250 questionnaires were collected from three medical centers and two regional hospitals. According to the results, physicians are more concern about security and privacy risk and performance risk among four facets of perceived risk. Perceived risk and resistance to change shows a direct and negative effect on behavioral intentions. And there is no significant relationship between perceived threat and Electronic Medical Record Usage Intentions.

並列關鍵字

Perceived Risk ； Perceived Threat ； Electronic Medical Record ； Resistance to Change

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