探討影響病歷資訊管理人員對電子病歷使用之研究：整合科技準備度與系統持續使用的後接受模式

An Investigation of Medical Record Management Professionals Continuance Intentions to Use Electronic Medical Records: Integrating Technology Readiness and Post-Acceptance Model

目的：電子病歷是資訊科技在醫療作業之創新應用，而相關研究指出當人員的 創新與持續變革的相容性越高，則充分運用新科技與持續使用以因應新的工作與流 程改變就越容易，因此本研究目的為確立影響病歷資訊管理人員使用電子病歷之因 素與滿意度。 方法：以系統持續使用後接受模式為理論基礎，結合科技準備度來發展本 研究架構，並針對已進入跨院電子病歷交換階段之醫院，以有使用電子病歷之病 歷資訊管理人員為研究對象，進行問卷調查。共發放121份，回收有效問卷101份 （84.2%），採用WarpPLS 4.0進行資料分析。 結果：病歷資訊管理人員科技準備度對態度與使用行為有顯著影響，其中樂觀 性、創新性、不安全性（負向）對認知有用達顯著；又樂觀性、創新性對電子病歷 期望確認有顯著影響；樂觀性則對持續使用有顯著影響；而對電子病歷期望確認對 認知有用性與滿意度有顯著影響；認知有用性對滿意度與持續使用有顯著影響。因 此病歷資訊管理人員具備良好之科技準備度，以及電子病歷之系統功能符合病歷資 訊管理人員任務需求將是系統發展與持續改善須關注之議題。結論：透過確立影響病歷資訊管理人員使用電子病歷滿意度與持續使用因素，可提供醫院推動電子病歷應用之同時，強化科技準備度與改善系統使用之有用性以提升應用效能。

Objectives: Electronic medical records (EMRs) are an innovative application of information technology in the medical field. Relevant studies have pointed out that when staffs are more innovative and accepting of change in general, they are more able to use new technologies to adapt to new jobs and procedural changes. Therefore, this study sought to understand medical information administrators' technology readiness index (TRI) as well as their satisfaction with and continued use EMRs. Methods: This study was to integrate technology readiness into the post-acceptance model of Information system continuance for explaining individuals' continuance of EMR usage. A total of 121 questionnaires were sent out, with 101 completed copies returned, indicating a valid response rate of 84.2%. The collected data was then analyzed by WarpPLS v4. Results: The results show that optimism, innovativeness and discomfort of TRI had significant effects on the perceived usefulness. The optimism and innovativeness had significant effects on confirmation. The optimism had significant effects on the continued use. Further, the perceived usefulness had a significant effect on the satisfaction and continued use. The confirmation had significant effects on the perceived usefulness and satisfaction. Conclusions: The establishment of factors that influence medical information administrators' satisfaction with and continued use of EMRs can be provided to hospitals for the promotion of EMR systems and to improve TRI, system use satisfaction, and EMR effectiveness.