| 摘要: | 行政院衛生福利部於13年補助跨院調閱電子病歷應用於基層診療服務上，讓國人至國內任何一家診所就診時，醫師可藉由電子病歷交換系統查詢病人過去的就醫資料，以提供病患持續性、完整性及連貫性的健康照護。雖然，電子病歷交換可提供病歷資訊共享、達到病人資訊透明化的好處，但回顧過去文獻都只探討技術系統層面、交換標準的議題，卻忽略了醫師在醫療環境中一直佔有很重要並特殊的角色與地位。因此，現階段之首要目標應該為讓醫師有意願使用電子病歷交換，才能真正有效提升醫療照護品質，並有助益於工作績效。有鑑於此，本研究目的為探討基層醫師使用電子病歷交換系統之績效影響。因此，本研究以Goodhue and Thompson(1995)所提出的任務-科技配適理論，探討基層醫療院所醫師使用電子病歷交換之任務、科技配適對於績效之影響，並整合計畫行為模式，檢視態度、主觀規範和知覺行為控制對使用意願相關因素所造成的影響。以基層醫療院所醫師為研究對象進行問卷調查，再以SMART PLS進行資料驗證分析。研究發現：「任務特性」對「任務-科技配適」具有正向之顯著影響(P<0.001)；「科技特性」對「任務-科技配適」具有正向之顯著影響(P<0.001)；「任務-科技配適」對「績效」具有正向之顯著影響(P<0.001)，「任務-科技配適」對「使用意願」不具有顯著影響(P>0.05)；「態度」、「主觀規範」對「使用意願」具有正向之顯著影響(P<0.05)，「知覺行為控制」則無影響(P>0.05)；「使用意願」對「績效」具有正向之顯著影響(P<0.05)。研究結論：醫師使用電子病歷交換系統之意願會受到態度、主觀規範影響；醫師使用電子病歷交換系統之績效則是會受到任務-科技配適、使用意願所影響。最後，透過本研究結果，可提供瞭解醫師對於使用電子病歷交換系統意願與績效的主要影響因素，以便進一步協助相關單位制定推廣電子病歷交換系統策略及實施，此外也提供電子病歷交換系統平台改善之參考依據，更能瞭解基層診所醫師對系統之需求，將可提升基層診所醫師使用之意願與績效。
Executive Yuan Ministry of Health and Welfare grant access to campus-wide electronic medical record used in primary treatment service in 2013, so that people in any country a clinic, physicians can with electronic medical records exchange system query patient data for medical treatment in the past to provide patient persistence, integrity and continuity of health care. Although the exchange of electronic medical records can provide medical information sharing, to achieve the benefits of patient information transparency, but the past literature only discuss technical system level, item exchange standards, but ignored the physician in the medical environment has always played a very important and special role and status. Therefore, the primary objective of this stage must be willing so that physicians use electronic medical records exchange, to be truly effective to enhance the quality of medical care, and help benefit from job performance. For this reason, purpose of this study was to explore primary care physicians use electronic medical records system affect the performance of the exchange. Therefore, Goodhue and Thompson (1995) proposed task - technology fit theory to explore Primary Care Clinic physicians use electronic medical records exchange of task, technology fit for the performance, and integrated theory of planned behavior review attitude, subjective norm and perceived behavioral control related to the behavioral intention of the impact. Primary care physicians in clinics for the study questionnaire, then SMART PLS analysis performed data validation. The results show task characteristics have significant positive influence (P<0.001) on task - technology fit. Technology characteristics have significant positive influence (P<0.001) on task - technology fit. Task - technology fit have significant positive influence (p<0.001) on performance. Task - technology fit was not significant positive influence (p>0.05) on behavioral intention. Attitude and subjective norms have significant positive influence (p<0.05) on behavioral intention, but perceived behavioral control was not influence (p>0.05). Behavioral intention have significant positive influence (p<0.05) on performance. Conclusions: physicians use electronic medical records exchange system will be the will of attitude, subjective norms influence, physicians use electronic medical records exchange system performance is influence by task - technology fit and behavioral intention. Finally, through the results of this study can provide the physician to understand the main factors for the use of electronic medical records exchange system performance and willingness to further assist in the development of the relevant units to promote the exchange of electronic medical record systems strategy and implementation, in addition also provides for improvement in the exchange of electronic medical records system platform reference, primary care physicians better understand the needs of system right, it will enhance the performance of primary care physicians and willingness to use. |
