| 摘要: | 近年來，政府積極的推動與發展電子病歷，各家醫院對於電子病歷的實施也視為院內重要發展之一，而導入電子病歷不但可增加醫療服務的效率，還可降低與減少不必要的醫療費用支出。倘若醫院全面納入政府推動之電子病歷互通計畫，只要透過健保晶片卡就可以讀取個人所有的門診資料、病歷摘要與檢驗報告資料等等。換句話說，電子病歷的實施已是各家醫院不可或缺的重要基礎建設之一。而事實上，使用電子病歷資訊系統不僅是醫師，也包含病歷資訊管理人員。電子病歷的推動，不僅是改變了病歷資料的蒐集、檔案管理以及書寫品質的管理模式，也改變了醫師的病歷書寫模式、病歷資訊管理人員的管理及病歷審查模式。有鑑於衛生福利部積極推動電子病歷資訊系統，目前仍缺乏一套完整評估電子病歷資訊系統之滿意度的方式。因此，本研究以DeLone and McLean(2003)資訊系統成功模型為基礎，以品質構面、電腦焦慮、信任為自變數來衡量病歷資訊管理人員對電子病歷資訊系統滿意度之影響。本研究以病歷資訊管理人員為研究對象進行問卷普查，共發出104份問卷，回收有效90份，有效回收率為87.6%，以SPSS以及PLS兩套統計分析軟體?進?回收樣本之敘述性統計分析及信?、效?檢定。再透過結構方程模式(Structural Equation Model, SEM)來驗證研究模式變數間的因果關係。本研究結果發現：「系統品質」、「資訊品質」、「服務品質」及「信任」對「滿意度」有正向影響，而「電腦焦慮」則對「滿意度」沒有顯著影響。根據本研究結果與建議，可提供未來研究者研究醫院其他資訊系統之重要參考依據，也建議未來醫療機構可針對推動電子病歷資訊系統後之效益進行評估，以瞭解推動電子病歷後對病歷資訊管理人員之衝擊。此外，亦期望本研究結果，能提供政府單位、醫療資訊產業對推動電子病歷之決策參考以及系統功能設計及推廣策略之參考依循。
Government is actively promote and development of the Electronic Medical Records(EMR), hospitals are implementation of EMR is also considered one of the important developments, while the import of EMR not only increase the efficiency of health care services, but also reduce and reduce unnecessary medical expenses. If hospitals fully integrated into the government plan to promote the interoperability of Electronic Medical Records, as long as health insurance through the individual IC card can read all of the patient information, medical records summary and inspection reports information and so on. In other words, the implementation of EMR is one of the hospitals indispensable infrastructure. In fact, the use of EMR is not only physicians, but also medical and health information manager. Promote EMR is changed the collection, review medical records mode and writing quality for physician and medical and health information manager. In view of the Ministry of Health and Welfare vigorously promote the EMR information system. Therefore, this study use information system success model by DeLone and McLean(2003) to be a main frame, and join the concept which the computer anxiety and trust, investigate the user satisfaction. Questionnaires were systematically distributed to medical information management with experiences of using Electronic Medical Records information system, and the establishment of the institute research hypothesis and conceptual model validation. There are 104 questionnaires sent and 90 valid questionnaires. The return rate of valid questionnaires is 87.6%. We analyze the data by applying the SPSS and PLS statistical software, and analytical methods include descriptive statistics, reliability analysis, validity testing This study adopts Structural Equation Model (SEM) to analyze the variables. The results showed that system quality, information quality, service quality and trust have significant positive effects on user satisfaction, and the influence from computer anxiety isn’t significant to user satisfaction. According to results, suggestions for this model can provide important reference study, after medical institutions use EMR can be evaluated for benefits in the future study. These findings are expected to provide hospitals, government agencies, healthcare information industry and academia to reference or use. |
