實施電子病歷廢除紙本保存之效益分析——以南部某醫學中心為例

A Benefit Analysis of the Implementation of Electronic Medical Records (EMR) to Replace Conventional Paper Ones - A Case Study Taken at a Hospital Medicine Center in Southern Taiwan

電子病歷是國家醫療發展重點，各醫療院所必然要投入資源發展，而醫院經營者除關心電子病歷資源互通共享效能外，也希望瞭解該政策推動的具體成本效益，本研究針對推動電子病歷無紙化後，以（一）節省紙張耗用成本、（二）儲存空間效益、（三）環保減碳效益、（四）節省人力工時效益及（五）作業流程改變等五個面向分析其效益。本研究結果為該院實施電子病歷而廢除紙本列印後，預估1年可省紙4,504,483張，約496公尺，即1.43棟「高雄85大樓」，節省紙張與列印成本為2,252,242元，換算為該院6排式病歷櫃約減緩存放檔案架需求約5.87座（約19平方公尺、5.75坪）；減少碳排放量為81,081公斤。門診病歷紀錄廢除紙本列印保存且不送病歷至診間，預估1年可節省人力工時25,447小時（換算約13人）；門診每天可節省護理人員工時共計18小時，約可多2.25人力運用，合計1年可節省紙張列印與人力成本約為7,892,242元。如全院均不調送實體病歷，預估病歷檔案管理人員1年約可節省36,102工作小時。

Electronic medical record (EMR) has now become an essential part of this country’s medical development. The resources that are needed to be invested in EMR become substantial in each and every medical center around. The key operators of the medical center should not only be very concerned about the efficiency of the resource sharing, but also the actual costs in promoting such policy. In this analysis study we focused on the five benefits of EMR. First, EMR greatly reduces the amount of printing paper. Second, the space required is considerably decreased. Third, the new method is much environmental friendlier. Fourth, less manpower and working time are required to accomplish the task. And fifth, the processing route of the medical records is changed for better. The results of the study show that once the medical center has shifted into the paperless EMR, 4,504,483 sheets of paper a year would be saved, which pile up to approximately 1.43 folds of the height of “Kaohsiung 85 Building.” The reduced cost of paper and other printing resources amounts to 2,252,242 NT dollars. It would also do without the need of 19 m2 of floor area to house 5.87 storage cabinets and 81,081 kilograms of carbon emission. The number of staff could be downsized is estimated at 13.25, which is converted from 25447 person hours saved in a year by simply no longer printing, storing, and sending paper version of medical records to the clinics each working day whenever being called for. After the implementation of EMR and without the bother of dealing with paper records, we estimate that 18 hours can be saved by the clinics nursing staff, or approximately 2.25 people can be deployed to other tasks. The grand total of the annual savings in costs and labor would be 7,892,242 NT dollars per year. If the entire center stops to a halt all delivering service of any written or printed medical records as they are still doing now, our Medical Record Management Department alone can save up to 36,102 person hours in a year.