資訊系統轉型對病歷作業行為模式的轉變――以國立臺灣大學醫學院附設醫院雲林分院為例

A Study on the Changes in Behavior Patterns of Medical Record Process Due to Information System Transformation – Taking Yun-lin Branch of National Taiwan University Hospital as an Example

隨著國內醫療與健保環境的轉變，以及各家醫院儀器設備推陳出新、專業人才技術延攬合作等競爭下，部分醫院漸漸尋求資源整併，本院（前身署立雲林醫院）於2004年4月1日改由臺大醫院接手，更名為臺大醫院雲林分院，而在過程中資訊系統之差異，是間接影響分院及總院體系銜接的最大障礙因素之一，而「人流、物流、資訊流」為臺大醫院體系發展的重要目標，故於2012年訂下體系資訊系統整合的策略目標，2013年開始籌備準備專案進行，整體轉換的成果，促使體系醫院在作業流程趨近一致性，及配合政策修正彈性較大。在大型的醫療機構中以全面性導入新的健康資訊系統，從醫療端、護理端到行政端一次性到位轉換，在國內鮮少見到。本篇藉以資訊系統轉型對於（電子）病歷管理及導入後行為模式的轉變做為探討方向，並提供轉換資訊系統所遇相關問題及先前準備之經驗做為分享。

Along with the transformation of medical and health care environment and competition in ever innovative hospital equipment, professional recruit, and technical cooperation, some hospitals have gradually learnt to seek integration of their resources. On April 1, 2004 this hospital (formerly the Departmental Yun-Lin Hospital) changed its affiliation and was renamed Yun-lin Branch of National Taiwan University Hospital (NTUH). During the change over period, one of the biggest indirect obstacles in linking the headquarters and the branch lay the differences in their process systems of information. And since NTUH was aiming at “smoothing out its internal flows of personnel, materials and information” as one of its top priorities in its expansion, we set our strategic objectives of information system integration in 2012, and started to prepare ourselves and work on projects step-by-step toward the set goals in 2013. Now, we are proud to show our overall conversion results so far, which are prompting the hospital workflow system approaching consistency, and the branch displays much greater flexibility in its responses to policy amendments from above. Among large hospitals in Taiwan, what we have accomplished is a quite rare case, in terms of bring about a wholesome transformation of our health information system and simultaneously on our medical, nursing, and administration fronts. This study was to look into the changes in behavior of the involved personnel after the introduction of (electronic) medical records in the transformation. Besides, we also try to provide our preparation experiences as well as the relevant problems encountered during our conversion for sharing.