電子化病歷系統下的病歷室人力配置對工作滿意度之影響

Coping with Electronic Medical Record System: Influences of Manpower Allocation in Medical Record Department on Job Satisfaction

全民健康保險支付制度的變革使得醫療院所必須降低成本以利永續經營，應用電子化病歷系統(Electronic Medical Records, EMR)來降低成本與流程改善成為必然的趨勢。本研究以深度訪談與問卷調查來瞭解個案醫院在EMR推行過程中對病歷室人力配置產生的衝擊，以及員工預估新的人力配置對其工作滿意度的影響。結果顯示病歷課主管認為X光檔案組相較於病歷檔案組與疾病分類組，受到EMR的衝擊最大，所以最早進行該組的人力轉任規劃。問卷調查共得73份有效問卷，結果顯示由於院方安排X光檔案組未來工作的規劃最為明確，因此該組對院方態度與正向態度都顯著高於其他兩組。組織在引進新科技進行變革時，管理階層應瞭解變革對員工可能產生的衝擊，利用溝通與明確的作法來協助員工因應變革，不僅可以降低員工的負向態度同時也可以提升其工作滿意度。

As governments struggle with rising care costs, healthcare providers have been forced to become more cost competitive. More recently, the possibilities offered by information technology such as Electronic Medical Records (EMR) enable today's providers to be more cost effective. However, the adaptation of EMR may result in unwanted impacts upon employees, especially those working in the Medical Record Department. The main purpose of this study, using a case study approach together with questionnaire survey, is to understand what impacts will be brought about by the implementation of EMR system to the medical record department and how the department can cope with the impacts in terms of job motivation and redesign. The results suggest that the EMR system have different impacts upon three subdivisions, namely filing division, X-ray imaging division, and encoding division. It is expected that tasks in the X-ray imaging division are largely taken over by the EMR system, so that principles for job reallocation have been implemented for this division. The implementation has shown to improve job satisfaction of workers in the X-ray imaging division. It is concluded that the administrator of the department needs to pay more attention to their employees' emotional reactions towards the EMR transition.