在高度知識密集的醫療產業，醫療專業人員知識及專業技能為醫院核心競爭優勢的主要來源。然而醫療專業人員龐大的工作負荷量與其高度專業自主的特質之下，醫療知識管理的推行存在著極大的障礙。綜觀醫院醫療知識管理的發展，線上臨床指引系統友善的資訊系統環境可謂為引導醫院進入醫療知識管理系統最有效的入門工具之一。醫療專業人員可以透過線上臨床指引系統，打破傳統空間與時間的限制，以增進醫療專業知識及技術，提昇知個人識管理能力，維持或提升醫院核心競爭力。
本研究針對某醫學中心使用線上臨床指引系統的使用者，發放200份問卷進行調查，有效回收195份，有效回收率為97.5%。問卷回收資料透過結構方程模式之偏最小平方法進行研究模式建立與假說驗證。
研究結果顯示，線上臨床指引的使用及使用滿意度對個人知識管理行為與個人淨效益具有顯著的正向影響，而個人知識管理行為與對個人淨效益具有部分顯著的正向影響。此外，個人知識管理行為及線上臨床指引使用滿意度對於線上臨床指引的使用及個人淨效益具有部分中介效果。另外，醫師偏向積極使用線上臨床指引系統的態度影響個人識管理行為，且可直接透過使用線上臨床指引系統的使用可達到個人淨效益效果；專科助理方面則認為線上臨床指引系統的使用會透過個人知識管理行為影響個人淨效益。 Health care is a high-intensive knowledge industry, therefore the knowledge and the skills of these medical staff are the key advantage for the hospital competitiveness. However, in these medical staff, their high workload and high professional autonomy have made the knowledge management difficult to implement in hospitals. Overview of the medical knowledge management development, the friendly information system environment of the online clinical guidelines is one of the most effective way to introduce the hospital into a medical knowledge management system.
Medical staff can not only improve their professional knowledge and skills by using on-line clinical guideline systems without the limitation of space and time, but also enhance their personal knowledge management ability and increase the hospital competitiveness.
This research aims to investigate the users who used the online clinical guidelines system in a southern medical center in Taiwan. Of the 200 questionnaires surveyed, 195 of them are effectively, leading to 97.5% effective response rate.
This research uses partial least squares(PLS) in order to verify the research model and hypotheses. The results showed the use of on-line clinical guidelines and user satisfactions are significantly and positively related to individual knowledge management behavior and individual net benefit. Individual knowledge management behavior is partial-positive related to the individual net benefit. In addition, the individual knowledge management behavior and the on-line clinical guidelines user satisfaction have mediating effect on the use of on-line clinical guidelines and individual net benefit.
Otherwise, in the physicians’ model, the use of on-line clinical guidelines system can affect their individual knowledge management behavior, hence, they can directly use the on-line clinical guidelines system to achieve individual net benefits effect., On the other hand, in the physician assistants’ model, the use of on-line clinical guidelines systems has to affect individual net benefits through enhancing individual knowledge management behavior.
