醫療資訊電子化後的安全與隱私－－以健保IC卡為例

Satisfaction of Privacy and Safety on NHI IC Card

先前研究已針對民眾對健保IC卡內容與使用態度進行過分析調查，接著則是實施健保IC卡較引人爭議的隱私權及安全性疑慮的問題研究。為了瞭解民眾使用現況、對於遺失換補手續的了解與隱私權及安全性憂慮程度，我們分析不同類別民眾及在各種使用情形下對此卡的隱私安全滿意度。本研究共發出750份問卷，回收有效問卷606份。結果顯示，87.9%的民眾有使用經驗；對於遺失換補手續中「申辦健保IC卡須繳交二吋大頭照」與「換補健保IC卡申辦的地點」二項，民眾的認知甚低（分別為14.4%與53.2%），尤以中年民眾與軍公教及工人在此二項的認知最差。不同性別與教育程度的民眾對遺失換補手續的認知則無顯著差異。對於IC卡各種隱私與安全性問題，44%至69%的受訪民眾會憂慮；其中女性對安全性的滿意度較低；教育程度較高的民眾對健保IC卡的安全性較有疑慮；不同職業及年齡則無顯著差異。有使用經驗的民眾對健保IC卡的安全性與滿意度有較正面的態度。整體而言，至少五成以上的民眾對於健保IC卡的安全性仍存有疑慮；近七成的民眾會擔憂將個人資料存於網路上會造成外洩。建議健保局應強化網路安全維護，並針對女性、高教育程度者加強健保IC卡的安全與隱私方面之宣導。

Our preliminary study showed that the cognition in contents and usage of NHI (National Health Insurance) IC card were different among various categories of populace. The next issues we further explored were the cognition in renewal procedure and the satisfaction of privacy and safety on NHI IC card. This study was carried out by structured questionnaires, the survey number was 750 and the valid questionnaires were 606. Our results showed that most populace (87.9%) had used NHI IC card, and low cognitions were found in ”photo size” (14.4%) and ”places for IC card's renewal” (53.2%), the cognitions were different among different age and occupation. Those aged 41~50, or the populace whose occupation were worker, military service, or teaching and official service had lower cognition scores. There were no differences among gender and different education levels. Around 70% surveyed populace would worry about the safety of personal medication information, which was digitized and stored in the internet, and 44% to 69% of populace would argue against the privacy and safety of NHI IC card, especially for the female or higher education populace. Populace who had experience of using IC card had more positive attitude toward its privacy and safety. In general, about 50% of populace would worry about the privacy and safety of NHI IC card, and most (70%) populace worried that the digitalized personal medication records stored in internet could be released improperly. According to our results, we made comments and suggestions for the references of Bureau of National Health Insurance in future propaganda.