應用「結合科技接受模式與計畫行為理論」的概念架構推動電子病歷之經驗－以某區域教學醫院為例

Applying the Conceptual Framework of ＂Combined Technology Acceptance Model and Theory of Planned Behavior (C-TAM-TPB)＂ to Implement Electronic Medical Records: An Example in a Regional Teaching Hospital

郭靜燕(Ching-Yen Kuo)；鄭舜平(Shun-Ping Zheng)；張舒婷(Shu-Ting Zhang)；賴雪鈴(Xue-Ling Lai)；詹前隆(Chien-Lung Chan)

電子病歷 ； 結合科技接受模式與計畫行為理論 ； 系統導入 ； 區域醫院 ； Electronic medical records ； Combined technology acceptance model and theory of planned behavior (C-TAM-TPB) ； System implementation ； Regional hospital

醫學與健康期刊

7卷1期（2018 / 03 / 01）

65 - 75

繁體中文

為提升病歷使用效率、降低人力成本、減少病歷儲存空間、配合電子病歷公共政策，需要早日全面實施電子病歷。方法為應用「結合科技接受模式與計畫行為理論」，成立電子病歷推動小組、建立主觀規範、設定電子病歷實施順序、改善資訊設備、提升知覺易用性、知覺有用性、進行宣導、設立電子病歷專責窗口、介入主觀規範、進行使用者接受度調查。實施成果為2015年12月1日門急診病歷全面實施電子病歷，效益為節省紙張耗用、病歷儲存空間減少、降低人員工時、減少等候病歷輸送時間、提高查閱病歷效率。首長決心、執行力及導入「結合科技接受模式與計畫行為理論」是成功關鍵，個案醫院實施經驗能作為其他尚未全面實施門急診電子病歷醫院之參考。

To improve the efficiency of medical records usage and reduce labor costs, hospitals need timely full implementation of electronic medical records (EMRs) systems. Based on the ＂Combined Technology Acceptance Model and Theory of Planned Behavior (C-TAMTPB)＂, an EMRs promotion group was organized to establish subjective norms, set up the implemented orders of EMRs, augment technologic information equipment, improve the perception of convenience and usefulness, intervene subjective norms and conduct a user survey. Since 1, December, 2015, EMRs for outpatient departments and emergency departments were implemented in the enrolled hospital. Increased efficiency was observed in terms of reductions in paper consumption, medical records storage space, staff working hours, and waiting times for medical records delivery. Exact exploration, execution and application of the C-TAM-TPB directed by the management officers are key points for the success of EMRs system implementation. This reported experience of implemented EMRs in a regional hospital can be referenced by other hospitals.

1. Ajzen, I(1985).From intentions to actions: A theory of planned behavior. Action control.Springer.
2. Ajzen, I,Fishbein, M(1975).Belief, attitude, intention and behavior: An introduction to theory and research.Reading, MA:Addison-Wesley.
3. Chen, CC(2013).The exploration on network behaviors by using the models of Theory of planned behaviors (TPB), Technology acceptance model (TAM) and C-TAM-TPB.African Journal of Business Management,7,2976.
4. CPRI(1995).Description of the computer-based Patient Record and computer-based Patient Record System.Schaumburg, IL:CPRI WORK Group on CPR Description.
5. Davis, FD,Bagozzi, RP,Warshaw, PR(1989).User acceptance of computer technology: a comparison of two theoretical models.Management science,35,982-1003.
6. Delone, WH,McLean, ER(2003).The DeLone and McLean model of information systems success: a ten-year update.Journal of management information systems,19,9-30.
7. DeLone, WH,McLean, ER(1992).Information systems success: The quest for the dependent variable.Information systems research,3,60-95.
8. Jen, W,Lu, T,Liu, PT(2009).An integrated analysis of technology acceptance behaviour models: Comparison of three major models.MIS Review,5,89-121.
9. Taylor, S,Todd, P(1995).Assessing IT usage: The role of prior experience.MIS quarterly,19,561-70.
10. Taylor, S,Todd, P(1995).Decomposition and crossover effects in the theory of planned behavior: A study of consumer adoption intentions.International journal of research in marketing,12,137-55.
11. Taylor, S,Todd, PA(1995).Understanding information technology usage: A test of competing models.Information systems research,6,144-76.
12. 尚榮基(2015)。電子病歷：臺灣大學醫學院附設醫院推動經驗。醫療資訊雜誌，24，13-9。
13. 范碧玉(2015)。病歷資訊管理學。台北=Taipei:合記圖書出版社=Hochi。
14. 徐嫦娥、簡郁沛(2010)。電子病歷之發展及法規政策。病歷資訊管理，9，1-18。
15. 陳向明(2014)。社會科學質的研究。台北=Taipei:五南圖書出版股份有限公司=Wunan。
16. 黃秋雪、張嘉晏、劉惠貞、張淑金、楊佳玲(2013)。建置紙本病歷掃描倉儲管理系統對醫院推動電子病歷之影響。病歷資訊管理，11，1-14。
17. 衞生福利部:衛生福利部電子病歷專區。http://emr.mohw.gov.tw/introduction.aspx。引用 6/6/2017。Health and Welfare Department: Ministry of Health and Welfare electronic medical records area. Available from: URL http://emr.mohw.gov.tw/introduction.aspx。Aceessed July 6, 2017. [In Chinese]

1. 陳柏青,陳宏銘,林麗娟(2021)。以科技接受模式探討高爾夫運動之穿戴式裝置應用。成大體育學刊，53(2)，1-25。
2. 潘彥蓁,劉仲矩(2019)。人力資源網站美學建構衡量重要性分析之研究。科技與人力教育季刊，5(3)，53-69。