運用QR CODE掃描上傳紙本病歷效益評估──以南部某醫學中心為例

Evaluating the Benefits of Using QR CODE Scanning to Submit Paper-based Medical Records--An Examples at a Medical Center in Southern Taiwan

病歷掃描是推動電子病歷過程中因為資訊人力或資源不足，結構化效益不高等等因素無法即時實施電子化或資訊化，但臨床又需要查閱或病人申請病歷複製、健保申報抽審需要提供資料的需求而研議的一種因應配套作業方式。本研究就空間、人力與作業流程三個面向比較傳統紙本管理、人工掃描、採QR CODE 方式之差異，效益如下：提高病歷管理品質：(1) 透過醫囑或檢查檢驗帶出紀錄表單供臨床填寫，減少紀錄缺漏，自動帶出病人基本資料而減少黏貼名條貼紙等護理行政作業(2) 完整、快速查閱診療過程應具備的各類紀錄與同意書(3) 解決部分複雜而尚未電子化之紙本病歷紀錄無法於資訊系統查閱的困境，提高醫療照護品質；人力工時效益：(1)QR CODE 掃描與人工掃描比較：每月可以節省375.6 小時，換算約2.3 人；以每小時180 元計算，則節省約67,613 元(2)簡化病歷檔案管理作業（抽調、傳送、歸檔），檔區人力可節省6 人，每月薪資節省18 萬；儲存空間效益：估算1 年產生110 萬紙本記錄，可節省1.5 坪；其釋出之空間可再作為門診或醫療服務價值更高。期許政府及早修法，可將過去紙本保存的病歷透過掃描保存合法性而銷毀，或掃描上傳之資料經由機構卡簽章視同合法之電子病歷後可銷毀，以利釋出空間再使用，強化醫療院所推動電子病歷的動力。

Medical record scanning is the process of promoting electronic medical records because of insufficient information, manpower or resources, low structural benefits, and other factors that cannot be implemented in a timely manner. Medical record scanning is a coping strategy because of the clinicians needs to review medical record, patient request for medical record copy, and needs for the selection of sampling examination in healthcare insurance cases. This study compares the differences between paper medical record management, medical record scanning, and QR Code scanning in the three different aspects of storage space, manpower, and work flow. The benefits are as follows: Improving the quality of medical records: (1) Bringing out record forms for clinical filling through doctor's orders or inspections, to reduce record omissions, automatically bring out basic patient information, and reduce physical nursing administrative processes such as distributing patient stickers; (2) Quickly completing the part of medical record on various and consent forms required; (3) Solving the dilemma that some complicated and not electronic paper records cannot be accessed in the information system, and improving the overall quality of medical care. The benefit of manpower and working time: (1) By using QR CODE scanning instead of manual scanning medical record at this particular hospital, 375.6 person hours can be saved per month, which translates to about 2.3 employees; calculated at 180 NT dollars per hour, it means a saving of about 67,613 NT dollars; (2) Simplifying the management of medical record file (sampling, transmission, and archiving), our Medical Record Management Department alone can save up to 6 people hours per month, and save around 180,000 NT dollars monthly salary. The benefit of storage space: It is estimated that 1.1 million paper records are generated in just one year, which storage needs 4.96 m2 of floor area; the freed space can be used as an outpatient rest area or for other medical service with higher value. It is hoped that the government can amend the law as soon as possible. It can be cautious about the legality of past paper-based medical records saved by scanning, or after scanning and uploading to sign by healthcare hospital card system and seal as legal electronic medical records, we can be cautious to free up space for reuse and strengthen the motivation of healthcare hospital to promote electronic medical records.