實證醫學可說是建置醫療知識管理的重要組成元素，且實證醫學與知識管理皆是促進醫療價值創新的重要途徑之一。然而有關實證醫學對於醫療知識管理能力與醫療價值創新影響的相關研究，以及衡量的相關構面的研究甚少。有鑑於此，本研究欲發展衡量實證醫學實施程度、醫療知識管理能力與醫療價值創新績效等相關構面在醫療業的衡量變項，並探討三者間的互動影響關係。
本研究以四家醫學中心之就職醫師為研究對象，採用問卷調查法做為主要的研究工具，總計發放320份問卷、實際回收之有效問卷為204份，而有效回收率達到63.75%。問卷回收資料透過因素分析與偏最小平方法(partial least squares , PLS)進行研究模式建立與假說驗證。
本研究將實證醫學實施程度的衡量，發展出「落實實證醫學的能力」、「以實證醫學進行學術研究」、「以實證醫學進行臨床決策」三個主要因素，並將醫療知識管理能力分為「知識分享能力」、「知識累積能力」、「知識利用能力」與「知識創造能力」四大主要因素。
本研究發現，實證醫學實施程度對醫療知識管理能力與醫療價值創新績效具有顯著的正向影響，而醫療知識管理能力對醫療價值創新績效具有顯著的正向影響。此外，醫療知識管理能力對於實證醫學實施程度與醫療價值創新績效具有部分中介效果。在醫療產業中醫療知識管理能力之「知識利用能力」與「知識創造能力」兩者，對於「醫療價值創新」的貢獻程度最大，其中更發現「知識累積能力」則是「醫療價值創新」的阻礙因素。 Evidence-based medicine (EBM) is an important element of implementing medical knowledge management. Both of them are also critical ways of medical value innovation. Nevertheless, there is rare research concerning the influence of EBM on medical knowledge management capability and medical value innovation performance, nor is the research on the measurements of those constructs. Therefore, this study aims to develop measurements on the degree of practicing EBM, medical knowledge management capability and medical value innovation performance, and also to discuss the interactions among the three constructs.
Survey was performed toward physicians positioning in four medical centers. 320 questionnaires were mailed and 204 effective were responded, reaching 63.75% of effective response rate. Exploratory factor analysis and PLS were conducted to analyze the data and verify the research model.
The study develops three dimensions on the practice of EBM, including the capability of practicing EBM, doing researching by EBM, and making clinical decision by EBM. Medical knowledge management capability is also defined by four factors including knowledge sharing capability, knowledge accumulation capability, knowledge utilization capability and knowledge creation capability.
Our study finds that EBM practice has positive influence on medical knowledge management capability and medical value innovation performance. Medical knowledge management capability has partial moderating effect on EBM practice and medical value innovation performance. In addition, knowledge utilization capability and knowledge creation capability have largest contribution on medical value innovation performance. Knowledge accumulation capability, otherwise, is a barrier to medical value innovation.
