| 摘要: | 隨著醫療知識與資訊技術日新月異，醫療專業人員必需不斷充實並更新醫學知識，醫療產業也紛紛發展電子病歷、實證醫學資料庫、線上臨床指引系統及臨床決策支援系統等資訊系統，能夠從中取得大量的臨床資料與醫學相關文獻，並加以管理。然而醫療院所往往礙於成本預算的考量，以及資源的有限性，而無法一次購足，須以漸進的方式購進。有鑑於此，本研究旨在建立醫療知識管理各準則之權重，並進一步針對上述四項醫療資訊系統進行醫療知識管理績效的評選，以提供主管機關作為參考。本研究首先使用修正式德爾菲法進行文獻探討，以設計第一階段問卷，並採用群體決策針對第一階段問卷結果進行18個次準則的相依關係之確認，隨後依據第一階段問卷結果設計第二階段問卷後，運用分析網路程序法(Analytic Network Process，ANP)進行分析，建立準則之權重，再進一步針對四項醫療資訊系統對於醫療知識管理績效之貢獻進行評選。研究結果顯示醫療知識管理之準則中，以「醫療知識分享」最具重要性，次準則中以「建立知識分享文化」和「與同儕分享知識」兩項最具重要性，而評選方案之優先順序依序為「實證醫學資料庫」、「線上臨床指引系統」、「臨床決策支援系統」與「電子病歷系統」。研究結果發現，醫療知識分享對醫療知識管理具有相當的重要性，而建立知識分享文化和與同儕分享知識對於醫療知識管理的貢獻最大，此外方案評選結果以實證醫學資料庫的醫療知識管理貢獻度最大，電子病歷系統的貢獻度則相對較低。
With the rapid development of medical knowledge and information technology, medical professionals must enrich and update medical knowledge constantly. Healthcase organization have developed electronic medical records, evidence-based medicine, clinical practice guidelines, clinical decision support systems and other information systems one by one, which can be obtained a lot of clinical data and medical literature,also manage it.However, because of the considerations of the cost budget and the finiteness of resources, therefore can't one-stop shopping, it must be purchased in a progressive manner. Therefore, this study aimed to establish the weight of each criterion of medical knowledge management, and evaluate the medical knowledge management performance of electronic medical records, evidence-based medicine, clinical practice guidelines, clinical decision support systems further, in order to provide a reference to competent authority.This study uses Modified Delphi Method to design the phase 1 questionnaire, and adopted group decision-making to confirm the dependence of the 18 sub-criteria, then according to the results to design the phase 2 questionnaire. This research using analytic network process to establish the weights of criteria, and further evaluate the contribution of the medical knowledge management performance of electronic medical records, evidence-based medicine, online clinical practice guidelines, clinical decision support systems.The results showed that the medical knowledge sharing is the most important criteria in medical knowledge management, and the most important sub-criteria is to build a knowledge sharing culture and to share knowledge with colleague. The priorities of the alternatives is evidence-based medicine, online clinical practice guidelines systems, clinical decision support systems and electronic medical records system.The results showed that medical knowledge sharing of medical knowledge management has considerable importance, and building a knowledge sharing culture and knowledge sharing with colleague for the greatest contribution to medical knowledge management. Further evidence-based medicine is the greatest contribution to medical knowledge management, on the other hand the electronic medical records's contribution is relatively low. |
