影響醫師使用分級醫療電子轉診系統因素與成效評估之初探

Factors determining physicians' perspectives on bidirectional electronic referral systems' use and performance

目標：確立影響醫師持續使用分級醫療電子轉診系統之關鍵因素與成效，以強化系統功能與服務需求，提昇病患持續照護品質，落實分級醫療制度的推動。方法：本研究以資訊系統持續使用的後接受模式為基礎，結合認知易用性、信任與使用成效，來探討影響醫師持續使用轉診系統之因素與使用成效，針對有使用轉診系統經驗之醫師進行問卷調查。回收有效問卷為121份（55.5％），採SmartPLS3.2.6進行資料分析。結果：影響醫師對電子轉診系統之期望確認、認知易用性、認知有用性、滿意度、信任對持續使用（R2＝0.584）皆有顯著影響，持續使用亦顯著影響使用成效（R2＝0.421）。其中使用成效以「能更有效率完成雙向轉診」、「提昇病患照護品質」及「有效掌握轉診病人的動態」為排序前三項。結論：結果可提供推動分級醫療轉診歷程中，持續關注影響醫師持續使用電子轉診系統之因素與使用成效，以作為系統改善的依據，促進醫療資訊流暢，達成分級醫療之利基。

Objectives: This study investigated physicians' perspectives on factors influencing the continuing use and performance of bidirectional electronic referral systems. Methods: The post-acceptance model of information system continuance was extended, with perceived ease of use, trust, and individual performance used to identify critical factors affecting bidirectional electronic referral systems' continuance and performance. A survey questionnaire was administered to collect data from physicians experienced in using such systems. Of the 218 questionnaires distributed, 121 valid questionnaires were returned, corresponding to a valid response rate of 55.5%. The data were analyzed using SmartPLS 3.2.6 software. Results: Continuance (R2 = .584) was mainly affected by confirmation, perceived usefulness, perceived ease of use, trust, and user satisfaction, whereas individual performance (R2 = .421) was affected by continuance. Moreover, the primary three performances of bidirectional electronic referral systems comprised the efficient completion of bidirectional referrals, enhancement of patients' quality of continuing care, and effective monitoring of patients' locations and activities. Conclusions: The findings serve as a reference for formulating a bidirectional referrals policy, charting bidirectional electronic referral systems' performance, and improving these systems. In addition, they provide insights into factors influencing physicians' continued use of these systems and facilitate the promotion of seamless medical information flows and the development of bidirectional referral niches.