近年來醫院資訊化之重要議題：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，因此醫院在面臨醫療環境之競爭日趨激烈，與政府積極推動以資訊科技進行醫療改革之前提下，都將電子病歷之發展視為重要之醫療資訊化方針。然而電子病歷的發展不僅僅是一個資訊系統的導入，還必須考慮到醫療人員以及機制等配合，因此了解與掌握影響發展電子病歷的關鍵因素，對於醫院成功的導入電子病歷將有很大的助益。因此本研究之目的為瞭解及確立醫院發展電子病歷上所面臨之困難與影響其持續發展之關鍵因素。
本研究以醫學中心及區域醫院(含)以上之醫院為研究範圍，利用郵寄問卷方式進行醫院與電子病歷推動之中高階主管的相關資料蒐集。共發放116份問卷，回收有效問卷63份，有效問卷回收率為54.3%。採用SPSS 17.0作為統計分析工具，並以複迴歸方法進行資料分析。研究結果：電子病歷之創新特性是影響醫院持續發展電子病歷之關鍵因素，創新之特性包含其相對優勢與相容性。
於醫院發展電子病歷之障礙因素之前六項為：1、患者對於隱私權保障的顧慮2、專門人員的培訓不易3、資訊安全維護困難4、法律規範不成熟5、成熟的技術不易取得6、政策不明確。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，研究結果可作為與2002、2005年及未來推動電子病歷比較分析之參考，以建立整體國內發展電子病歷之脈絡，同時與其它國家之電子病歷發展進行比較，降低電子病歷推動之阻力，有效的落實健康照護資訊化之願景。 In recent years, one of the most important issues had come into the sights of healthcare information technology: the promotion and development of electronic medical records (EMR). The EMR is not only the focus of the Department of Health, but also the policy of the hospital towards the u-Healthcare. As the hospital are facing the increasing competition in the healthcare environment while the government actively promote information technology as the base for health care reformation, the development of EMR will be regarded as an important principle of medical information technology. However, the development of EMR is not just an information system to import; it must take into account the medical staff and the mechanisms in a hospital to complete the tasks. That’s to say, understanding and grasping an empirical study of critical factors influencing the development of EMR will do much favors for the hospital successfully adapted and EMR system. The purpose of this study is to explore and identify the difficulty that hospital should facing when establishing the EMR systems and the key factors influencing the sustainability of the continuing development.
The study methodology was employed with the medical centers and regional hospitals in Taiwan as the scope of the study hospitals. By using mailed questionnaires to the top executives of the hospitals to collect the relevant data about the hospital and the activity for EMR promotion. A total of 116 questionnaires were mailed and 63 valid questionnaires were return with a 54.3% response rate. Using SPSS 17.0 as statistical analysis tools and Multiple Regression analysis was applied to the data. The results of this study revealed that information quality which was constructed as relative advantage and compatibility is the key factor significantly influencing on benefits.
According to the weights, the prior six barriers which impact on the development of EMR in hospital are: 1. the privacy protection concerns of the patient; 2. the difficulty in specialized staff training; 3.The difficulty to maintain information security; 4.Immature legal norms; 5.The difficulty to obtain mature technology; 6.The ambiguity of the policy. By way of identifying the key factors and difficulties which influenced the establishment and development of EMR, corresponding to the direction of the government’s efforts, it pointed the way to achieve a win-win results that both the government and practitioners in EMR industry. The results can be used with the reports in 2002, 2005 and that in future years to promote the comparative analysis of EMR progression while establishment of overall domestic Development of the EMR context was achieved. At the same time, with the data of developments and progressions of EMR from other countries, the comparisons reduce the resistance to promote of EMR and achieve effective implementation of the vision of health care information technology.
