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題名 | 醫師使用隨身碟電子病歷意願之研究=A Study on Physicians' Acceptance of USB-flash-drive Electronic Health Record |
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作 者 | 溫信財; 陳琬茹; 簡文山; 楊沛墩; 李友專; 陳筱茹; | 書刊名 | 病歷資訊管理期刊 |
卷期 | 10:1 2010.12[民99.12] |
頁次 | 頁42-58 |
分類號 | 419.26 |
關鍵詞 | 可攜式電子病歷; 科技接受模式; 醫師; Portable electronic health record; Technology acceptance model; TAM; Physicians; |
語文 | 中文(Chinese) |
中文摘要 | 背景:電子病歷已成?國際間,以資訊科技提升醫療照護品質的主要發展趨勢。而病歷的主要製作與使用者?醫師,若無臨床醫師的支持及參與,電子病歷導入的益處將無法發揮,故本研究目的?瞭解醫師對於醫院資訊科技之使用現況,以及對可攜式電子病歷之認知與使用意願,並進一步探討影響其使用意願之相關因素。 方法:本研究乃一橫斷式量性研究,研究對象?參與衛生署「建構以病人?中心之電子病歷跨院資訊交換環境案」參與醫院內之醫師,含括了北、中、南及東部共計9家醫學中心。科技接受模式?基本研究架構,研究工具?自填式結構性問卷,經信度及效度檢定後,以定額方式寄發至每家醫院,共計回收437份,有效問卷?426份,有效樣本回收率?25.6%。 結果:影響醫師使用可攜式電子病歷之因素?:科技認知因素(包含知覺有用性、知覺易用性及瞭解使用流程程度)(p<0.001)、電腦自我效能(p=0.038)及外在環境因素(包含加註電子簽章使用權限及管控機制)(p=0.013),模式可解釋49.1%之變異量(Adjusted R^2=0.491)。 結論:知覺有用性、易用性及瞭解使用流程?影響醫師使用可攜式電子病歷之主要因素,由於受訪醫師並不滿意紙本病歷之整體環境,對使用可攜式電子病歷流程瞭解亦偏低,在此情況下,將是醫院推動及發展電子病歷的契機,而政府主管機關提供對醫療院所的補貼或獎勵誘因,提供服務及教育訓練,將有助其於電子病歷的研究及推廣。 |
英文摘要 | Background: Electronic health record (EHR) has become a main-stream information technology (IT) development worldwide for the purpose of enhancing healthcare quality. Due to the fact that health records are mainly created and used by physicians, it appears that the advantages of EHR could not be fully taken without their support and participation. The main purposes of this study were to understand the various EHR systems current used by physicians, the latter's cognition and willingness of using portable EHR, and to explore the relevant influential factors of physicians' acceptance to portable EHR. Methods: This study adopted a quantitative cross-sectional approach, and our subjects were physicians from nine medical centers, which participated in Taiwan DOH's ”Building of an Information Exchange Environment for Cross-Hospital Digital Medical Record” project. A Technology Acceptance Model (TAM) was the basic scheme of our research design. A set of structured questionnaire and 5-points Likert Scale were used as our research tool. After a reliability and content validity test, certain numbers of copies of the questionnaire were sent to each of the nine medical centers. After all, 426 copies of the questionnaire were returned and found valid, and the effective response rate was 25.6%. Results: The factors affecting physicians' acceptance to portable EHR were: technical cognition (including perceived usefulness, perceived easiness of use, and familiarity with portable EHR process) (p<0.001), computer self-efficacy (p=0.038), and some external environmental factors (including adding remarks, electronic signature, time stamp, authorization limits, and access control) (p=0.013). The explanation power of model R^2 was 49.1% (adjusted R^2=0.491). Conclusions: Perceived usefulness, perceived easiness of use, and familiarity with EHR process were found to be the three major factors influencing physicians to accept the portable EHR. Since most of those physicians having bothered to answer the questionnaire were not satisfied with the overall traditional paper medical record environment and also not willing to familiarize themselves with portable EHR process, it appears to be a good timing for the hospital to promote and develop HER system. If the government could offer some incentives like funds or subsidization to encourage hospitals to provide services and educational trainings, it would be very helpful to the research and promotion of HER. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。