近年來隨著雲端運算的興起，讓醫療資訊可結合網際網路與雲端科技，發展出一套創新的醫療服務。尤其，讓醫師透過健保雲端藥歷查詢，不僅可減化工作流程、提昇工作效率與病患安全之外，還可減少醫療資源的浪費。但回顧過去相關文獻指出，資訊科技的導入經常會遭受到醫師的抗拒，而導致建置失敗無法實現其效益。有鑑於此，本研究回顧過去對於資訊系統使用與抗拒的文獻，以 Cenfetelli(2004) 所提出資訊科技使用的雙因子觀點，整合科技接受及使用者抗拒理論，提出醫師接受與抗拒健保雲端藥歷查 詢的研究模型，突顯出使用意圖與抗拒的前因以及行為的後續影響。因此，本研究採用 實證研究方法，以參加衛生福利部中央健康保險署健保雲端藥歷系統線上查詢作業之醫院名單為樣本來源，並採用系統抽樣方式針對醫師進行問卷調查；再以結構方程模式進行資料分析，來驗證研究模式變數間之因果關係，藉以評估與驗證本研究模式的解釋能力。最後，邀請 2~3 位醫院的專家進行深度訪談，藉以瞭解前述的分析結果。因此，期望本研究之成果能作為中央衛生主管機關、醫院與醫療資訊產業對於健保雲端藥歷查詢之實施策略及績效評估之參考，並增益學術界對於健保雲端藥歷系統之成功與持續使用衡量之相關研究。 The latest technological trends such as Cloud Computing provide a strong infrastructure and offer a true enabler for health information services over the Internet. Especially, national health insurance PharmaCloud query allows physicians to streamline many of their processes and provide patient safety in a more efficient and cost-effective manner. Despite some practitioners and academics emphasize the opportunities that cloud computing offers hospitals, their overall adoption remains low and meets resistance from physicians. There are gaps in our understanding of how physicians evaluate change related to the national health insurance PharmaCloud query and decide to resist it. Thus, this study proposes a preliminary model of PharmaCloud query acceptance and resistance, highlighting its causes and effects, by synthesizing prior findings in the information system (IS) usage and resistance to change literatures, using a recently proposed dual-factor structure of IS usage (Cenfetelli, 2004) as the bridge between these two literatures. This theoretical model is then empirically validated using survey data from practicing physicians in the Taiwan. The results of this study provide valuable suggestions about how to promote physicians’ willingness to adopt the national health insurance PharmaCloud query, which can be useful for other hospitals currently implementing a PharmaCloud system.
