建立以行動裝置為使用平台之緊急救護資訊系統－－以東部某縣市EMT人員為研究對象

Establishing an Emergency Medical Service Information System on Mobile Devices-- A Case Study of EMT in Eastern Area of Taiwan

緊急救護資訊系統最重要之處，在於利用新穎且成熟的科技並配合救護人員的專業技術，來提高醫療救護的整體品質，以減少病患痛苦及死亡，根據統計，救護車從事故災難發生地點將病患送至醫院急診室的平均時間，在都市約為十多分鐘，偏遠地區則約為四十分鐘，目前EMT(Emergency Medical Technician)人員除須在這段時間之內維持病患的生命徵象外，亦須以手寫的方式來紀錄病患的基本資料、生命徵象與求救原因等相關資料，並以無線電告知醫院病患狀況，因此若能將這些過程輔以資訊系統，讓EMT人員更方便的填寫，並可將多餘的時間用來照顧病患，將有助於提升緊急醫療救護之整體品質。本研究旨在建立以行動裝置為使用平台的緊急救護資訊系統，使EMT人員可以用點選的方式，簡化救護紀錄表之填寫過程。除此之外，本研究亦連接1C卡讀卡機與電子血壓計等相關電子儀器設備，協助EMT人員做資料蒐集與疾病的判斷，給予病患更適切的照護進而提高填寫品質，並將所蒐集的資料轉換為TMT(Taiwan Electronic Medical Record Template)的標準格式，做為EMT人員將資料傳回消防分隊存查之用，此外若醫院方面願意採用相關標準，亦可直接將這些資料匯入醫院的檢傷分級等內部系統，減少表單的填寫，以期在意外狀況發生時，能夠減少醫療資源的浪費，進而挽救更多寶貴的性命。開發完成的系統經過模擬測試與實際測試後施以問卷調查，結果發現系統平均滿意度為23.64分，紙本滿意度則為21.26分，兩者相差為2.38分，此差異經由t-test檢定後據統計上之顯著意義(P=0.004)，表示EMT人員認為本研究所開發的系統對他們以及緊急救護整體品質的提升確實是有幫助的。

The most important function of an emergency medical service (EMS) information system is to enhance the overall quality of emergency medical services with information technology, cooperated with professional skill of Emergency Medical Technician (EMT), and thereby reduce the pain and incidence of death among emergency patients. According to the statistics, the average travel time for an ambulance to commute from the accident location to the emergency room of a hospital is about ten minutes in cities and around 40 minutes in remote areas. Currently, EMTs strive to maintain the vital signs of patients during this time and document the patient's demographic data, vital signs, reasons for needing emergency aid and during the same time, the hospitals should be informed of the patients' conditions. If we using an EMS information system to assist EMTs in those processes of above, so EMTs can fill out the data sheet more conveniently, then the EMTs can use the extra time to better serve the medical needs for the patient. The purpose of this study was to evaluate the effectiveness of an emergency medical service information system for mobile devices. In addition, the study examined the process of connecting electronic equipment such as an IC card reader and an electronic sphygmomanometer as aides in helping the EMT gather data and judge the patient's condition in order to offer more appropriate care. The generated data sheet was then transformed into TMT (Taiwan Electronic Medical Record Template) format as set up by this study. This data format can also be automatically converted into the hospital information system format in order to avoid previously redundant standard paper work. The study's questionnaire was responded to by EMTs who had used the information system in field practice. Compared to the traditional paper work, the results of the t-test analysis showed a significantly higher level of satisfaction among those EMTs who used the information system. The study provided evidence that the system could be really helpful to EMT.