台灣醫療機構實施電子病歷之探討

Exploration of Implementing Electronic Medical Records in Taiwan

電子病歷泛指醫療機構為了提供照護服務而產生的電子化病歷。電子病歷不僅能解決多人同時調閱病歷的問題，而且還有助於改善病歷的完整性、正確性和即時性。從過去的研究指出，電子病歷可以協助提升醫療服務效率、增進病人安全、降低醫療成本和改善醫療品質等。我國從2000年起開始推動電子病歷，由早期發展單一醫院的電子病歷試辦計畫，逐漸進行跨院際的電子病歷垂直整合，近年來更進一步導入國際醫療標準，促進跨體系、跨區域的電子病歷交換與流通。本文分析我國歷年來推動電子病歷的政策、執行方案和實施成果，藉此提出系統性的探討，提供醫療院所發展電子病歷的參考。

Electronic health record (EHR) can be defined as a secure, real-time, point-of care, patient centric information resource for clinical care and other uses such as research and education. It can be considered as a subset of each care delivery organization (CDO)'s electronic medical records (EMR) or episodes of care across multiple CDOs. According to past research, EHR can improve the quality of medical services, increase patient safety, and reduce medical costs. Taiwan's government has been promoting the EHR adoption for more than 10 years since 2000. Initially the Department of Health (DOH) had launched trial projects with a focus on development of EMR systems for a single hospital or several hospitals within a health group, and then launched large-scale pilot projects to demonstrate the feasibility of exchanging EMRs among hospitals across different health groups and different regions. In recent years (until now) the DOH has established standards and developed a nation-wide EHR exchange center for the exchange of EHRs. In this paper, we analyze Taiwan government's strategies and the current progress of EHR adoption. This report may help medical care providers or hospitals developing their policies for the implementation of EMR systems and facilitating sharing of electronic medical records across multiple hospitals within a community, region, or nation.