近年來，電子病歷之推動與發展，不僅是衛生署關注之焦點，也是醫院朝向u化(u-Healthcare)之方針，然而衛生署在過去幾年之電子病歷推動中，仍面臨了政策誘因不足，病人資料之使用權限、個人隱私權之保障、資通安全尚未完成確立與醫療院所配合等問題，而有相當大的阻力。因此，衛生署乃積極進行我國電子病歷推動相關之策略。然上述立場是從政府之觀點所進行之策略與執行方案，企圖降低電子病歷推動之阻力與困難，但醫療機構在進行電子病歷發展上，所面臨之問題與影響其持續發展電子病歷之因素，是否與政府努力與改善之方向相符，是一項值得探討的議題。因此本研究目的為確立在影響醫院發展電子病歷之關鍵因素與困難。研究將以醫院評鑑合格(含)以上醫院為研究範圍，以問卷進行醫院電子病歷推動之高階主管的相關資料蒐集。透過確立影響醫院發展電子病歷之關鍵因素與困難，來對應政府努力與改善方向之相符性，以達到產官對電子病歷推動雙贏之目的，同時本計劃是推動電子病歷評估之參考資料，可作為與2005年及未來推動電子病歷比較分析之研究參考。而透過建立整體國內發展電子病歷之脈絡，可與其它國家之電子病歷發展進行比較，讓電子病歷之推動之阻力降低，有效的落實健康照護資訊化之願景。 In the past decade, the settlement and further development of the Electronic Medical Records (EMR) became the political focus of the department of Health and the milestones toward U-healthcare of the hospitals. However, there still existed some barriers for the goals to be achieved, such as no enough political supports from the government, the assessment authorization for the private health in formations of the patients, the assurances of patient privileges and data communication, and the non-cooperation of the hospitals. The efforts from the department of health had tried to push the policy to carry on, while all the strategies and tactics came from the scopes of the government to wear down the resistances and the difficulties. In the other side, the obstacles facing by the hospitals to practice EMR may not well fit the direction that the government tried to push. In this study, the key difficulties and factors that the hospitals wanted to conquer were attempted to be identified. The top managers of the hospitals qualified by joint committee were surveyed with questionnaire to collect the relevant data. By identification of the compatibility of the key difficulties and factors that hospitals facing and the policies that the Department of Health were carried on, the study would do some help for the goals of EMR practices. At the same time, this study could be included in the references list for the evaluation of EMR promotion programs to make comparison with that performed in 2005 and that done in the future. Besides, while settlement of the chronicles of the promotion of EMR, and comparison between our milestones with those data from other countries, we should reduce the resistance for the promotion of EMR and efficiently achieved the vision of the settlement of health care information.
