探討醫師及藥師對健保有端藥歷系統期望和感受之間的差異分析

Discrepancies between Desired and Perceived Measures of Performance of the National Health Insurance Pharma Cloud System by Physicians and Pharmacists

本研究旨在探討不同使用者對健保雲端藥歷系統期望和實際感受。因此，透過比較使用者期望與實際感受之間的差異來瞭解影響使用者滿意度和淨利益的主要因素。本研究採問卷調查法，以某區域教學醫院之醫師及藥師為研究對象，並以變異數分析及迴歸分析來驗證假說，總計蒐集有效問卷共94份。驗證結果顯示：(1)醫師群：系統品質、資訊品質及服務品質的期望與感受程度之間的差異對使用者滿意度有顯著影響；(2)藥師群：系統品質、資訊品質及服務品質的期望與感受程度之間的差異對使用者滿意度有顯著影響；(3)無論醫師群或藥師群之健保雲端藥歷查詢的滿意度對淨利益有正向顯著影響。於學術研究上，本研究說明整合資訊系統成功模型和差異理論可應用於健康雲端使用研究上，可供後續進行更廣泛的模式推導與探討；於實務應用上，研究結果顯示不同使用者對系統期望與感受之間的差異是不同的。因此，醫院管理者和健保署必須根據不用使用者群對健保雲端藥歷系統期望與感受之間的差異，評估系統實施的效益與提升績效之重要參考依循。

This study aims at combining the information system success model and discrepancy theory to evaluate user's satisfaction and net benefit. By comparing user’s gap between want and have, we can understand the influencing factors of user satisfaction and net benefit on information systems. A survey was conducted from the physicians and pharmacists of a regional hospital. ANOVA and regression analysis method was employed to test the research hypotheses. There were 94 usable responses. The results indicated that: (1) For physician group, the gap of system quality, information quality, and service quality effect on user satisfaction; (2) For pharmacist group, the gap of system quality, information quality, and service quality effects on user satisfaction; (3) In overall, user satisfaction appears to have a positive direct effect on net benefit. Implications for research, our study illustrates the importance of information system success model and discrepancy theory in health information usage studies in particular, grounds for discrepancy theory that can serve as the starting point for future research in this relatively unexplored yet potentially fertile area of research. Implications for practice, each group had a different set of expectations, indicating that the measures did not represent the same expectation or meanings to different stakeholders. That, hospital management and the National Health Insurance Bureau (BNHI) should strive to promote uniform understanding of the measures employed in system performance evaluation by all stakeholders expectations according to the metrics selected.