應用「結合科技接受模式與計畫行為理論」的概念架構推動電子病歷之經驗－－以某區域教學醫院為例

Applying the Conceptual Framework of ＂Combined Technology Acceptance Model and Theory of Planned Behavior (C-TAM-TPB)＂ to Implement Electronic Medical Records: An Example in a Regional Teaching Hospital

為提升病歷使用效率、降低人力成本、減少病歷儲存空間、配合電子病歷公共政策，需要早日全面實施電子病歷。方法為應用「結合科技接受模式與計畫行為理論」，成立電子病歷推動小組、建立主觀規範、設定電子病歷實施順序、改善資訊設備、提升知覺易用性、知覺有用性、進行宣導、設立電子病歷專責窗口、介入主觀規範、進行使用者接受度調查。實施成果為2015年12月1日門急診病歷全面實施電子病歷，效益為節省紙張耗用、病歷儲存空間減少、降低人員工時、減少等候病歷輸送時間、提高查閱病歷效率。首長決心、執行力及導入「結合科技接受模式與計畫行為理論」是成功關鍵，個案醫院實施經驗能作為其他尚未全面實施門急診電子病歷醫院之參考。

To improve the efficiency of medical records usage and reduce labor costs, hospitals need timely full implementation of electronic medical records (EMRs) systems. Based on the ＂Combined Technology Acceptance Model and Theory of Planned Behavior (C-TAMTPB)＂, an EMRs promotion group was organized to establish subjective norms, set up the implemented orders of EMRs, augment technologic information equipment, improve the perception of convenience and usefulness, intervene subjective norms and conduct a user survey. Since 1, December, 2015, EMRs for outpatient departments and emergency departments were implemented in the enrolled hospital. Increased efficiency was observed in terms of reductions in paper consumption, medical records storage space, staff working hours, and waiting times for medical records delivery. Exact exploration, execution and application of the C-TAM-TPB directed by the management officers are key points for the success of EMRs system implementation. This reported experience of implemented EMRs in a regional hospital can be referenced by other hospitals.