以資訊系統成功模式探討醫師使用行動醫療之重要因素

Explore the Critical Factors for Physicians Using Mobile Health by Information Systems Success Model

我國評鑑等級為區域醫院以上者，大都已具備相當完善的醫院資訊系統，近年來，許多醫院在原有資通訊基礎及衛生福利部推動下，努力推展行動醫療（Mobile Health，mHealth），使臨床工作人員能即時得到正確及完整的病患資訊，以提升醫院診治流程與管理效益，並促進醫療照護品質。本研究測試對象為北部某教學醫院使用「行動醫療資訊系統」之臨床醫師，參考DeLone & McLean的資訊系統成功模式，以問卷進行調查，共發放308份問卷，回收129份問卷，有效問卷126份，有效回收率為40.91%。結果發現，系統品質的任務急迫性（Taskurgency）（P＝0.225**t＝2.594）；資訊品質的格式（Format）（P0.203**t＝2.591）和服務品質的服務同理心（Empathy）（β＝0.336**，t＝3.294）對醫師使用「行動醫療資訊系統」滿意度有顯著的正向影響。而使用者「滿意度」會正向影響醫師的「使用意願」（P＝0.635***，t＝10.329），及「個人效益」（P＝0.294**t＝3.735）；最後，「使用意願」會正向影響醫師使用行動醫療資訊系統的「個人效益」（P＝0.633***，t＝8.232）。醫院經營者雖投入可觀之經費及人力推動行動醫療資訊系統，但要達成預期效益，在功能品質、資訊品質及服務品質上應符合使用者之需要，讓臨床醫師因使用滿意而產生使用意願，進而達到預期之「個人效益」。因此，相關醫療機構在導入行動資訊系統時，需重視系統使用者之滿意度，以提升系統建置之成功率。

Most accredited regional hospitals in Taiwan have built up comprehensive Hospital Information System (HIS). Recently, based on the original infrastructure of information and communication system and government support, some hospitals actively developed Mobile Health information system (mHealth). By using mHealth, clinicians can get real-time patient's information at any place of hospital to enhance administrative efficiency and improve healthcare quality. Our study subjects were physicians who have used the mHealth at a northern teaching hospital of Taiwan. We used 'The DeLone and McLean Model of Information Systems Success' as the study framework and the questionnaire was developed accordingly. Questionnaires were distributed to 308 physicians, 126 out of 129 returned were valid, and the response rate was 40.91 %. The results showed that Task urgency of system quality (β=0.225 **, t=2.594), Format of information quality (β=0.336 * *, t=2.591), and Empathy of service quality (β=0.336 **, t=3.294) had significantly positive effect on physicians' satisfaction with mHealth. Moreover, the user satisfaction had positive effect on usage intention (β=0.635 ***, t=10.329) and personal benefit (β=0.294 ***, t=3.735). Ultimately, the usage intention had positive effect on personal benefit (β=0.633 ***, t=8.232) of mHealth. Hospitals have invested lots of money and manpower to set up the mHealth for improving administrative efficiency and quality of care. The function quality, information quality, and service quality of mHealth should satisfy physicians' need, and then achieving the goal of personal benefit. Therefore, hospitals should strive for meeting physicians'' satisfaction while developing mHealth to install the system successfully.