| 摘要: | 隨著網際網路的技術日趨成熟，其運用於醫療保健的價值亦大幅增加，有鑒於此，衛生福利部中央健康保險署在民國102年7月提出健保雲端藥歷查詢系統，健保雲端藥歷提供特約醫事服務機構醫師於臨床處置、開立處方，及藥師用藥諮詢時可即時查詢病人過去 3 個月的用藥紀錄，讓醫師可以更快速的了解病人的用藥資訊及進行醫療決策，以避免重複用藥的危險性，讓民眾在用藥上更有安全性，也可以降低醫療的成本。但回顧過去相關文獻指出，資訊科技的實施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。所以本研究目的在於1.瞭解醫師使用健保雲端藥歷查詢之現況；2.由UTAUT的觀點，探討「績效期望」、「努力期望」、「社會影響」及「促進條件」對於健保雲端藥歷查詢使用意願的影響；3.探討醫師對第三方網路平台的安全機制也就是制度信任，應用在科技接受上，對於健保雲端藥歷查詢使用意圖的影響。在回顧過去在醫療資訊相關領域裡的文獻中，以整合性科技接受使用模式來做為基礎並用來了解使用者的行為，皆獲得了良好的解釋能力。因此，本研究將以整合性科技接受使用模式來作為探討醫師對於健保雲端藥歷查詢使用意圖的理論基礎，並整合制度信任來探討醫師對健保雲端藥歷使用意圖的?為模式，並提出7個假說。而本研究採用問卷調查法，以醫院等級分為三的級別，對醫師進行調查，本研究共發放出150份問卷，有效回收142份的問卷，有要回收率為94.6%，之後再以結構方程模式及SPSS統計軟體來驗證研究假說。本研究結果表示績效期望、努力期望、社會影響及制度信任最為顯著(P<0.001)，而情境常態與結構保證對制度信任為顯著(P<0.001)。期望本研究之成果，能作為中央衛生主管機關、醫院與醫療資訊業對健保雲端藥歷執行與管理策略之參考，並增益學術界對健保雲端藥歷之成功與持續使用衡量之相關研究。
With Internet technology matures, its value is also used in health care a substantial increase in view of this, the Ministry of Health and Welfare Department's Central Health Insurance proposed NHI Cloud medication record query system in the Republic of China in July 102, NHI drug Cloud calendar providing special medical services physicians in clinical management, prescribe, and pharmacists drug counseling for immediate query of patients over the past three months, medication record, so that the physician can more quickly understand drug information of patients and medical decision-making, in order to avoid duplication dangerous drugs, so that more people on medication safety, can also reduce the cost of care. But the past literature noted that the implementation of information technology often suffer physician resistance, resulting in build failure can not realize its benefits. Therefore, this study aimed to 1. Understand the physician to use the status of health insurance Cloud medication record query of; 2 by the UTAUT point of view, to explore "performance expectations", "efforts to expect," "Social Impact" and "promote the conditions" for health insurance Cloud medication record query uses intentions; 3. Discussion physician network platform of third-party security mechanism is institutional trust, acceptance of applications in science and technology, health care for the cloud medication history queries intended use of. In the past in the medical literature related to the field of information in order to accept the use of integrated science and technology-based mode to do and to understand user behavior, it is the ability to get a good explanation. Therefore, this study will be integrated using the technology acceptance model as a theoretical basis for health care physician to explore cloud medication history queries intended use and integration of institutional trust to explore behavioral patterns of health care physician intention to use the cloud medication history, and proposes seven hypothesis. The present study used questionnaires to hospital level is divided into three levels, the physician investigated in this study were distributed out of 150 questionnaires, 142 valid questionnaires recovered, the recovery has to be 94.6%, after then to structure equation model and SPSS statistical software to verify hypotheses. The results of this study indicate performance expectations, and strive to expectations, institutional trust and social impact of the most significant (P <0.001), while the normal situation and the institutional structure to ensure trust significant (P <0.001). Expected results of this study can be used as the central health authorities, hospitals and medical information industry to the health-care drugreference calendar Drive Executive and Management Strategies, and gain the academic success of health insurance Cloud medication history of research and sustainable use of the measure. |
