影響病患授權電子病歷交換意願之因素──整合信任與健康信念模式

Factors Influencing Patients’ Willingness to Authorize Exchange of EMR-Integrating Trust and Health Believe Model

「台灣健康雲」成功推動的關鍵因素之一是電子病歷交換必須獲得病患授權。然而，在民眾日益重視隱私權的年代，如何讓病患願意授權電子病歷交換，實為一重要課題。本研究主要探討影響病患授權電子病歷交換的因素為何。研究方法為問卷調查法，對象為某醫院之門診病患，採隨機抽樣300名進行資料收集，回收有效問卷248份。結構模式分析結果顯示，資訊隱私顧慮對電子病歷交換授權的意願並沒有直接影響，而是透過知覺益處和知覺障礙間接影響其意願。此外，社會規範亦是影響授權電子病歷交換意願的決定因素之一。在實務上，本研究結果可提供醫療院所與政府單位在制定相關政策之參考依據；在學術上，更強化健康信念模式在廣泛健康行為的解釋能力。

The one of critical successful factors of “Taiwan’s health clouds” is under the authorization of the access to patients’ electronic medical records. However, in the age of increasing the right of privacy, how to make patients willing to authorize electronic medical record exchange becomes an important issue. The purpose of this study is to explore the factors that will influence on the patient’s willingness to authorize electronic medical record exchange. In this study, the questionnaire survey was employed and randomly distributed to 300 outpatients in a hospital, of which 248 valid questionnaires were returned and analyzed. Results of this study indicate that information privacy concern is not directly associated with the willingness of patient’s electronic medical record exchange, but through perceived benefits and perceived barriers to affect it. In addition, social norm is another key factor affecting the willingness of patient’s electronic medical record exchange. The results of this study can be a reference for medical institutions and governmental agencies to make relevant policies; for academics, the results of this study enhance the explanation power of HBM on general health behaviors.