近年來隨著資訊科技及醫療產業的蓬勃發展，在全民健康保險制度實施的影響下，電子病歷的推動及發展已經是不可避免的趨勢。電子病歷的實施，除能有效地提升醫療機構在經營上的競爭力，對於醫療人員在臨床作業上也提供了莫大的助益。在目前醫療環境市場競爭下，醫療服務政策的發展創新，都需要建立在提供病人更佳醫療照護服務為基礎的思維上，以達到「病人為中心」的健康照護服務。認知是一種主觀反應，也是態度衡量的方法之一，因此本研究之目的是探討病人及家屬對電子病歷實施的同意程度及其對醫療品質的影響。
本研究係以某教學醫院門診病人及家屬為對象，利用問卷進行調查，研究工具採結構式問卷，共發放250份問卷，有效問卷200份，有效樣本回收率為80.0%。蒐集之資料採用描述性統計、t檢定、相關分析與複迴歸等分析方法進行結果分析。
研究結果顯示，受訪者對電子病歷實施的呈現高度同意程度，調查發現，在受訪者對電子病歷的實施能提升就醫安全、避免重複檢驗檢查用藥，以及達到臨床資訊共享，降低醫療資源浪費，均有一定的同意程度，同時也代表受訪者對該醫院在電子病歷實施後對醫療品質的認同。在病人隱私及資料保護方面則是受訪者較擔心的部份，如何強化電子病歷存取的安全作業及保護隱私的信心，為當前重要且亟須重視的議題。 In recent years, with the rapid development on information technology and medical industry, the implementation of National Health Insurance system inevitably gives fresh impetus to electronic medical records. Putting electronic medical records into practice not only effectively enhances the competitiveness of the healthcare institutions, but also benefits the medical care for their daily clinical tasks. In the current healthcare environment, the innovation of healthcare services should depend on the thought of providing best healthcare service to patients in order to meet the goal of “patient-centered”. No more than their subjective response, perception is also a way to measure patients’ attitude toward the implementation of electronic medical records. The purpose of this study aims at exploring the consent degree of patients and their families towards electronic medical records and their impact on the healthcare quality.
This study employs a structured questionnaire survey approach to collect data. 250 questionnaires were distributed and the questionnaires were requested to be completed by patients and their families from outpatient departments in a teaching hospital. Of the 250 returned questionnaires, 50 are incomplete. The remaining 200 valid and complete questionnaires were used for the quantitative analysis. It represents a useable response rate of 80.0%. Data analysis is conducted by performing descriptive statistics, t-test, correlation analysis and multiple regression analysis.
The results show that the implementation of electronic medical records is positively associated with high consent degree in terms of improving patient safety, avoiding repetitive examination and drug doses, sharing clinical information, and reducing waste of medical resources. All these results also show that patients identify with the healthcare quality after the implementation of electronic medical records. However, respondents are more concerned with patients’ privacy and information security. Therefore, the issues how to strengthen the access control for electronic medical records and to assurance patients’ privacy should be pay much more attention.
