近年來，為提供持續性的醫療照護，加速病人診療決策，提昇醫療服務品質，減少 醫療資源浪費，政府己積極推動跨院間的電子病歷交換與互通，以加速不同醫院間醫療 資訊的整合與共享，目前也已獲得初步成果(208 家醫療院所通過電子病歷檢查，其中 150 家通過電子病歷交換互通查驗)。由於醫師是病患醫療服務的主要提供者以及決策 者，其對於電子病歷交換的態度，將是影響跨院電子病歷交換的推廣與成效之關鍵。因 此本研究將以探討說服與態度改變的思考可能性模式作為理論基礎，以瞭解影響醫師跨 院電子病歷交換態度之關鍵因素。主要採用問卷調查法針對國內區域級以上且通過電子 病歷交換互通查驗的醫院之醫師進行資料蒐集。本研究透過文獻探討與專家會議，推導 並修正研究架構雛形、變數及問卷，再以修改後問卷採用滾雪球抽樣方法，針對研究對象進行問卷調查。所蒐集資料將以最小平方法(PLS)之結構方程模型統計工具進行分 析。因此，本研究結果不僅能深入瞭解影響醫師對於跨院電子病歷交換態度的重要因素，相關建議更可作為政府與醫療產業推廣電子病歷交換的重要參考。 Recently, for achieving the continuum of care, facilitating clinical decision making, improving quality of care, and reducing the unnecessary waste of limited medical resources, the government of Taiwan has made some progressive acts in promoting cross-hospital exchange and interoperability of electronic medical records in order to facilitate the sharing and integration of medical information between hospitals. Nowadays, 208 hospitals have passed the requirements and standards of electronic medical records and 150 hospitals also have been certified to support cross-hospital exchange of electronic medical records. Physicians are the major service providers and decision maker in providing medical services. Therefore, physicians’ attitudes toward cross-hospital exchange of electronic medical records play key roles in the further promotion of exchange of electronic medical records. This study aims for understanding the key factors influencing physicians’ attitudes toward cross-hospital exchange of electronic medical records based on the theoretical foundation of elaboration likelihood model, which is proposed to understand the influencing processes of attitude change among individuals. The survey methodology will be conducted for validating the proposed research model. The respondents of this study are physicians of the hospitals (regional or medical center hospitals) that have been certified to support cross-hospital exchange of electronic medical records. A research framework will be proposed based on the results of literature reviews and then this framework will be revised by practical and academic experts of healthcare, information management, and cross-hospital exchange of electronic medical records. A validated questionnaire derived from the revised framework and corresponding questionnaire will be used to validate the proposed research model. By using the snowball sampling strategy, the data collected from the survey will be analyzed through partial least square statistical analysis technique. Thus, this study will provide an in-depth understanding for the reasons influencing physicians’ attitudes toward cross-hospital exchange of electronic medical records. In addition, it can contribute to Taiwan government and healthcare industry in making appropriate incentives for promoting cross-hospital exchange of electronic medical records.
