影響診所電子病歷互通系統使用意圖之因素

The Factors Affecting Clinics’ Use Intention of Interoperable Electronic Health Records System

郭怡葶(YI-TING KUO)

指導教授 ： 何政勳 ； 溫信財

國立臺北大學/商學院/資訊管理研究所/碩士(2016年)

摘要

隨著醫療體系的電子化，電子病歷逐漸取代紙本病歷，而電子病歷的使用也隨著政府的推廣已漸趨成熟，伴隨著政府對於電子病歷交換一連串的規劃，各大醫療院所進入電子病歷資訊交換的階段，藉著電子病歷交換的興起，政府隨之推出電子病歷互通系統，以協助電子病歷的交換。本研究將透過電子病歷互通系統，探討醫療體系下使用電子病歷互通系統交換電子病歷的情況，首先透過文獻探討的方式發展出本研究之研究架構，以科技接受模型為中心向外延伸，探討科技接受模型的外部影響因素，並根據本研究情境與電子病歷互通系統之特性，做影響因素的篩選，而除了電子病歷互通系統本身特性外，本研究亦加入外部壓力之影響做探討，分別以政府政策觀點以及外在壓力觀點進行探討。完成研究架構發展後，開始進行研究問卷之設計，問卷題項除了透過文獻的彙整外，亦邀請5位資訊領域與醫療領域專家做內容效度的審查，並透過舉辦座談會的方式進行問卷前測，根據前測結果調整問卷題項，使問卷之題項更加嚴謹以及契合研究情境。最後，以各地區診所醫師為受測對象，進行正式問卷之發放，透過與電子病歷互通系統之建置廠商的協助發放紙本問卷，總共發出1343份問卷，回收有效問卷之樣本數為1066份，回收率高達79.37%。根據診所向醫院調閱電子病歷的情況，以及政府政策推廣電子病歷互通系統之情況，本研究藉由資料分析結果，探討各個構面之間的關係，並針對各假說進行討論，最後提出結論與建議。

關鍵字

電子病歷 ； 電子病歷交換 ； 電子病歷互通系統 ； 政府政策 ； 外在壓力

並列摘要

With development of the health care, the use of electronic health records along with the promotion from government has become mature. Through the government planning a series of interoperable electronic health records, most medical institutions enter into the phase of interoperable electronic health records, and promote interoperable electronic health records system, to assist the exchange of electronic health records. In this study, explore the use of interoperable electronic health records system under the madical environments by use interoperable electronic health records system. First review the literature to develop the research framework of this study, using technology acceptance model to be the center of research framework, and explore technology acceptance model of external factors, according to the situation of study and the characteristics of interoperable electronic health records system, to select influencing external factors. In addition to the interoperable electronic health records system itself, this study also added the influence of external pressure, Government Support and External Pressure to explore. Than began to design questionnaire, not only aggregate questions of the questionnaire from literature, but examined by 5 medical and informational experts, and adjust questionnaire more rigorous by the organization of seminars. Finally, all regions of the clinic physicians be the tested objects, and distributed through the paper questionnaires. After distributed 1343 questionnaires, collected 1066 valid questionnaires. At last investigate the relationship between the various facets and discussed each hypothesis by the results of data analysis.

並列關鍵字

Electronic Health Records ； Interoperable Electronic Health Records ； Interoperable Electronic Health Records System ； Government Support ； External Pressure

參考文獻

趙福義，(2004)，以資訊技術提升護理品質及改進對病人的照顧。取自http://ir.lib.ncku.edu.tw/handle/987654321/19023

王贊富，(2005)，運用格網概念於醫療資訊系統。取自台灣博碩士論文系統。

Abrahamson, E., & Rosenkopf, L. (1993). Institutional and competitive bandwagons: Using mathematical modeling as a tool to explore innovation diffusion. Academy of management review, 18(3), 487-517.

Adams, W. G., Mann, A. M., & Bauchner, H. (2003). Use of an electronic medical record improves the quality of urban pediatric primary care. Pediatrics, 111(3), 626-632.

Adler-Milstein, J., Green, C. E., & Bates, D. W. (2013). A survey analysis suggests that electronic health records will yield revenue gains for some practices and losses for many. Health Affairs, 32(3), 562-570.