| Summary: | 碩士 === 國防醫學院 === 公共衛生學研究所 === 103 === Abstract
Background: In recent years, the processes on the promotion of healthcare services industry information have been different among many countries on the world. However, it’s absolutely a global issue that how to record the medical/health record completely and precisely, and strengthen medical records, storage, management, transfer and share and support decision-making functions. In addition, we should use information and network technology properly to make electronic medical records present its core functions, which is improving the quality of care and reducing health care costs. The above are concerned and should carry on striving in healthcare services industry.
Objective: (1) To figure out the existing electronic medical record architecture, its workflow and management mechanism in the primary medical care institutions to analysis its pros and cons, and provide the suggestions and improvements. (2) To explore the important factors on implementing E.M.R. Exchanging in primary health care institutes. (3) To evaluate Physicians’ satisfaction with exchange of electronic medical records exchanging center (EEC) and their concerning importance about EEC by Importance-Satisfaction Analysis method. These result of this study could be a virtual pilot reference on expanding E.M.R. exchanging system in the future.
Methods: The study involved 76 primary clinics which were participating in the pilot project in 2013year supported by Ministry of Health and Welfare. Research tool are qualitative questionnaire in the first phase and semi structured questionnaire to survey the effect on implementing EEC system on primary health care. Besides, applying technology acceptance model (TAM) and importance-satisfaction analysis to explore the major factor about the intention of physicians to using EEC. In addition, to evaluate that physicians think about the importance and satisfaction of EEC system platform.
Results: The results of this study point out that “physicians' views on policy promotion of EEC,” has positive affect on “satisfaction with EEC system platform” and “use of EEC system.” The more positive “cognize about E.M.R. Exchanging“, and the higher “satisfaction with HIS information system provider's customer service” the Physician felt, the better “satisfaction with the function of EEC system” he had."Medical information real-time updates and content integrity,” “the waiting time of access to medical records" and "does not affect the working of HIS system.” These problems all are prioritize improvement issues. In Taiwan, promoting the successfully electronic medical records exchanging to work on primary care should improve from three aspects：" actual administration on primary care", "EEC platform operating system," "policy establish", so that It could facilitate expansion to promote EHR interoperability applies to national primary clinics in the future, to enhance the usage of EEC, and to reduce the waste of medical resources, improve the quality of care, continuity of medical care on patients.
Keywords: electronic medical records, electronic medical records exchange, electronic medical records exchange center, technology acceptance model, the importance - performance analysis, the importance - satisfaction analysis
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