請用此 Handle URI 來引用此文件：
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66519完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 翁崇雄(Chorng-Shyong Ong) | |
| dc.contributor.author | Chia-Long Lee | en |
| dc.contributor.author | 李嘉龍 | zh_TW |
| dc.date.accessioned | 2021-06-17T00:40:14Z | - |
| dc.date.available | 2017-02-16 | |
| dc.date.copyright | 2012-02-16 | |
| dc.date.issued | 2012 | |
| dc.date.submitted | 2012-01-19 | |
| dc.identifier.citation | 中文部份
台灣健康資訊交換第七層協定協會（2011）．HL7簡介．上網日期：2011年08月07日． 網址：www.hl7.org.tw/attach/doc/HL7describe.doc. 行政院衛生署電子病歷推動專區（2011）．電子病歷推動成果．上網日期2011年09月11日． 網址：http://emr.gov.tw/introduction.aspx 研華科技（2008）．由CPOE到行動護理建構無所不在的醫療服務．上網日期：2011年08月28日． 網址：http://www.advantech.tw/sector/medical/News.aspx? doc_id=%7BEDC3679D-64FC-4B3F-B424-4EA788D3376 邱皓政 (2002)．量化研究與統計分析．台北市：五南。 林震岩 (2006)．多變量分析：SPSS的操作與應用．台北：智勝。 馬春媛 (2008)．影響企業員工使用數位學習系統意圖之研究－結合科技接受模型與主觀規範因素．未出版之碩士論文，國立中央大學企業管理研究所，中壢市。 病人安全資訊網（2011）．病人安全週．上網日期：2011年08月28日．http://www.patientsafety.doh.gov.tw/big5/default.asp 陳淑鳳（2001）．電子化政府下國稅稽徵人員資訊科技接受行為模式之研究．未出版之碩士論文，國立中山大學公共事務管理研究所，高雄市 張金鐘（2002）．以科技接受模式探討教師與學生採用數位化教材的態度．未出版之碩士論文，國立中山大學資訊管理研究所，高雄市。 葉春蘭，王慧瑜，陳麗芳（2010）．某醫學中心抗生素電腦醫囑試算功能實驗成效分析：以Aminoglycosides抗生素為例．藥學雜誌，26:76-80。 葉振山，張世杰（2009）．探索全民健保環境下使用電腦化之醫令輸入系統產生的非預期結果．若瑟醫護雜誌，3:24-37。 楊世瑩（2005）．SPSS統計分析實務．台北市：旗標。 鄭瑞娥（2007）．企業員工數位學習系統接受度之研究．未出版之碩士論文，國立中山大學企業管理研究所，高雄市。 英文部分： Aggelidis, V.P., & Chatzoglou, P.D.(2009). Using a modified technology acceptance model in hospitals. Int J Med Inform, 78:115-126. Arning, & Ziefle(2007). Understanding age differences in PDA acceptance and performance. Comput Hum Behav, 23(6):2904-2927. Bates, D.W., & Gawande, A.A.(2003). Improving safety with information technology. N Engl J Med, 348:2526-2534. Bates, D.W., Teich, J.M., Lee, J., Seger, D., Kuperman, G.J., Deborah Boyle, N.M., & Leape, L.(1999). The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc, 6:313-321. Chau, P.Y.K., & Hu, P.J.H.(2002). Investigating healthcare professionals’ decisions to accept telemedicine technology: an empirical test of competing theories. Information & Management, 39:297-311. Chen, C.C., Wu, J., & Crandall, R.E.(2007). Obstacles to the adoption of radiofrequency identification technology in the emergency rooms of hospitals. Int J Electron Healthcare, 3:193-207. Compeau, D. R., & Higgins, C. A. (1995). Computer Self-Efficacy: Development of a Measure and Initial Test. MIS Quarterly, 19(2):189-211. Croteau, A.M., & Vieru, D.(2002). Telemedicine adoption by different groups of Physicians. The 35th Hawaii International Conference on System Sciences Davis, F.D.(1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Quarterly;13:319-340. Davis, F.D., Bagozzi, R.P., & Warshaw, P.R.(1989). User acceptance of computer technology: A comparison of two theoretical models. Management Science, 35:982-1003. Do, N.V., Barnhill, R., Heermann-Do, K.A., Salzman, K.L., & Gimbel, R.W.(2011). The military health system’s personal health record pilot with Microsoft HealthVault and Google Health. J Am Med Inform Assoc; 18:118-124. Duyck, P., Pynoo, B., Devolder, P., Voet, T., Adang, L., & Vercruysse, J.(2008). User acceptance of a picture archiving and communication system. Applying the unified theory of acceptance and use of technology in a radiological setting. Methods Inf Med, 47:149-156. Frankovich, J., Longhurst, C.A., & Sutherland, S.M.(2011). Evidence-based medicine in the EMR era. N Engl J Med; 365:1758-1759. Garets, D., & Davis, M.(2005, October). Electronic patient records: EMRs and EHRs, concepts as different as apples and oranges at least deserve separate names. Retrieved August 21, 2011, from http://www.providersedge.com/ehdocs/ehr_ articles/Electronic_Patient_ Records-EMRs_and_EHRs.pdf Goth, G. A.(2008). game changer? As Google and Microsoft put their PHR plays into action, CIOs formulate their next moves. Healthc Inform; 25:52-54. Henson, R.K.(2011). Understanding internal consistency reliability estimates: A conceptual primer on coefficient alpha. Measurement and Evaluation in Counseling and Development, 34:177-189. HimssAnalytics(2011). EMR adoption model. Retrieved August 28, 2011, from himssanalytics Web site: http:// www.himssanalytics.org/ Holden, R.J.(2010). Physicians’ beliefs about using EMR and CPOE: In pursuit of a contextualized understanding of health IT use behavior. Int J Med Inform, 79:71-80. Holden, R.J., & Karsh, B.T.(2010). The technology acceptance model: its past and its future in health care. J Biomed Inform, 43:159-172. Jha, A.K., DesRoches, C.M., Campbell, E.G., Donelan, K., Rao, S.R., Ferris, T.G., Shields, A., Rosenbaum, S., & Blumenthal, D.(2009). Use of electronic health records in U.S. hospitals. N Engl J Med; 360:1628-1638. Kohn, K.T., Corrigan, J.M., & Donaldson, M.S.(1999). To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press. Leape, L.L., Berwick, D.M.(2005). Five years after To Err Is Human: What Have We Learned? JAMA; 293:2384-2390. Liang, H., Xue, Y., & Wu, X.(2006). User acceptance of computerized physician order entry: An empirical investigation. Int J Healthcare Inf Sys Inform, 1:39-50. Long, A.J., Chang, P., Li, Y.C., & Chiu, W.T.(2008). The use of a CPOE log for the analysis of physicians’ behavior when responding to drug-duplication reminders. Int J Med Inform, 77:499-506. Melas, C. D., Zampetakis, L. A. Dimopoulou A., Moustakis, V.(2011). Modeling the acceptance of clinical information systems among hospital medical staff: An extended TAM model. Journal of Biomedical Informatics, 44:553-564. Pare, G., Sicotte, C., & Jacques, H.(2006). The effect of creating psychological ownership on physicians’ acceptance of clinical information system. J Am Med Inform Assoc, 13:197-205. Palacio, C., Harrison, J.P., & Garets, D.(2010). Benchmarking electronic medical records initiative in the US: a conceptual model. J Med Syst; 34:273-279. Rosenthal, D., Seeman, E., & Gibson, S.(2001). Computerized physician order entry (CPOE): A study of physician technology acceptance, The 7th Annual Conference of the Southern Association for Information System (pp.147). Rovner, J.(2004, May 7). HHS chief unveils electronic medical records initiative. CongressDaily Sachidanandam, S.(2006). Why physicians do or do not use computerized physician order entry systems: Applying the technology acceptance mode. Ohio: Bowling Green State University. Simon, S.R., Kaushal, R., Cleary, P.D., Jenter, C.A., Volk, L.A., Orav, E.J., Burdick, E., Poon, E.G., & Bates, D.W.(2007). Physicians and electronic health records – A statewide survey. Arch Intern Med, 167:507-512. Tung, F.C., Chang, S.C., & Chou, C.M. (2008). An extension of trust and TAM model with IDT in the adoption of the electronic logistics information system in HIS in the medical industry. Int J Med Inform; 77:324-335. Venkatesh, V. (2000). Determinants of perceived ease of use: Integrating control, intrinsic motivation, and emotion into the technology acceptance model. Information systems research, 11, 342-365. Venkatesh, V., & Bala, H.(2008). Technology acceptance model 3 and a research agenda on interventions. Decision Sciences, 39:273-315. Venkatesh, V., & Davis, F.D.(2000). A theoretical extension of the technology acceptance model: Four longitudinal field studies. Management Science; 46:186-204 Venkatesh, V., Morris, M.G., Davis, G.B., & Davis, F.D.(2003). User acceptance of information technology: Toward a unified view. MIS Quarterly, 27:425-478. Wang, P.C., Cheng, C.H., Lin, H.Y., Kao, C.L., Huang, C.S., & Chou, C.J.(2009) HFMEA-initiated safety improvement in chemotherapy by using CPOE system. Asian Society for Quality in Health Care. December 2009, special supplement, 4-5. Wu, J.H., Shen, W.S., Lin, L.M., Greenes, R.A., & Bates, D.W.(2008). Testing the technology acceptance model for evaluating healthcare professionals’ intention to use and adverse event reporting system. Int J Qual Health Care; 20:123-129. Wu, J.H., Wang, S.C., & Lin, L.M.(2007). Mobile computing acceptance factors in the healthcare industry: a structural equation model. Int J Med Inform, 76:66-77. Yarbrough, A.K., & Smith, T.B.(2007). Technology acceptance among physicians. Med Care Res Rev, 64:650-672. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/66519 | - |
| dc.description.abstract | 當美國國家科學院的Institute of Medicine出版了”To Err is Human”後，資訊科技（IT）已逐漸廣泛的被用在醫療產業以提升病人安全及醫療品質，醫療用IT的建置在目前已經是可行而且實用。然而系統的推廣常因醫生過於忙碌及根深蒂固的醫療文化所阻礙。
本研究旨在探討一北臺灣醫療網所屬醫院內，包含了醫學中心，區域醫院及地區醫院，採用科技接受模式（Technology Acceptance Model, TAM）分析各院區推動電子化住院醫囑（Computerized Physician Order Entry, CPOE）的影響因素。 總共203位實際操作的醫護人員接受問卷訪問，人員有住院醫師、主治醫師以及專科護理師，內容包含電腦自我效能、CPOE使用經驗、認知有用性、認知易用性、滿意度和使用意願。 經分析統計發現，如同國外研究報告，TAM在國內亦可適用於醫療照護產業，同樣的認知有用性和認知易用性乃是主導使用意向和使用意願之原動力，影響因素依序是認知有用性，其次是認知易用性，第三是滿意度。再者若使用者每週使用電腦5小時以上者，對於電腦自我效能有提升作用。而電腦自我效能和以前有CPOE使用經驗則會顯著的影響認知易用性，接者影響認知有用性和滿意度。而認知有用性可影響滿意度和使用意願。但是醫院的主管當局的態度以及建置時間的長久，也是要考慮的因素之一。 | zh_TW |
| dc.description.abstract | Since the publication of “To Err is Human” by the Institute of Medicine in 1999, patients’ safety and care quality has become the top priority task force for every hospital. Application of information technologies (IT) in current era is feasible and practical. However, implementations of IT systems always encounter entry barriers, especially by doctors due to their heavy work load and practice culture.
After implementation of computerized physician order entry (CPOE) system in the hospitals of a medical health network in Northern Taiwan, 203 medical personnel who had used the system were investigated by using constructed questionnaires. Those include medical residents, visiting staff and nurse practitioners. With applications of the technology acceptance model (TAM), factors such as computer subjective effectiveness, experience in using CPOE, perceived usefulness (PU), perceived ease of use (PEOU), behavior intention of use (BI) and actual system use were studied and analyzed. As with other reports, TAM is a practical model in healthcare IT. In the present survey, PU and PEOU are still the factors that precede the BI and resultant actual use. Previous CPOE experience and computer subjective effectiveness can influence PEOU which in turn affects PU and BI. Nevertheless, PU can lead to BI and actual use. One’s usage of computer over 5 hours per week has positive effect on computer subjective effectiveness. The proposed study explained 60.5% of accumulated explained variance. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T00:40:14Z (GMT). No. of bitstreams: 1 ntu-101-P98747011-1.pdf: 1828067 bytes, checksum: 1ac52295750dcae7cbf7ee5a11cf8b96 (MD5) Previous issue date: 2012 | en |
| dc.description.tableofcontents | 口試委員審定書 ------------------------------------------- I
謝辭 ---------------------------------------------------- II 中文摘要 ----------------------------------------------- III 英文摘要 ------------------------------------------------ IV 目錄 ------------------------------------------------------V 圖目錄 -------------------------------------------------VIII 表目錄 ---------------------------------------------------IX 專有名詞列表 ----------------------------------------------X 第一章 緒論 ---------------------------------------------- 1 1.1 前言 --------------------------------------------- 1 1.2 研究背景與動機 ----------------------------------- 1 1.3 資訊科技與醫療產業 ------------------------------- 3 1.4 台灣醫療品質與病人安全的現況 --------------------- 7 1.5 台灣電子病歷推動之現況 --------------------------- 8 1.6 研究目的 ---------------------------------------- 11 第二章 文獻探討 ----------------------------------------- 12 第三章 研究方法 ----------------------------------------- 16 3.1 研究流程 ---------------------------------------- 16 3.2 研究架構與假設 ---------------------------------- 16 3.3 問卷設計 ---------------------------------------- 17 3.4 研究對象 ---------------------------------------- 18 3.5 統計方法 ---------------------------------------- 18 第四章 資料分析與研究結果 ------------------------------- 20 4.1 研究對象之分佈情形 ------------------------------- 20 4.2 工具信、效度、及CPOE系統調查問卷之得分情況 ------- 21 4.3 因素分析 ----------------------------------------- 24 4.4 基本資料與認知有用性、認知易用性、使用意願、滿意度、電腦自我效能之差異 -------------------------------------- 29 4.5 電腦自我效能、CPOE使用經驗與認知、滿意度及使用意願之相關分析 ------------------------------------------------ 33 4.6 結構方程式取向的路徑分析 ------------------------- 33 第五章 結論與建議 --------------------------------------- 39 5.1 研究結論與討論 ----------------------------------- 39 5.2 建議 --------------------------------------------- 43 參考文獻------------------------------------------------- 45 附錄一 CPOE問卷表-------------------------------------- 50 附錄二 CPOE問卷表手寫意見-------------------------------55 附錄三 基本資料與認知有用性、認知易用性、使用意願、滿意程度、電腦自我效能構面之交叉分析表--------------------------58 | |
| dc.language.iso | zh-TW | |
| dc.subject | 科技接受模式 | zh_TW |
| dc.subject | 電子化住院醫囑系統 | zh_TW |
| dc.subject | CPOE (Computerized physician order entry) | en |
| dc.subject | TAM (Technology acceptance model) | en |
| dc.title | 醫院建置電子化住院醫囑系統的影響因素－
以北台灣某醫療網為例 | zh_TW |
| dc.title | Factors Influencing Implementation of Computerized Physician Order Entry (CPOE) in Hospitals － Experiences From a Medical Health Network in Northern Taiwan | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 100-1 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 林永松(Yeong-Shung Lin),黃旭明(Xu-Ming Huang) | |
| dc.subject.keyword | 電子化住院醫囑系統,科技接受模式, | zh_TW |
| dc.subject.keyword | CPOE (Computerized physician order entry),TAM (Technology acceptance model), | en |
| dc.relation.page | 110 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2012-01-19 | |
| dc.contributor.author-college | 管理學院 | zh_TW |
| dc.contributor.author-dept | 資訊管理組 | zh_TW |
| 顯示於系所單位： | 資訊管理組 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-101-1.pdf 未授權公開取用 | 1.79 MB | Adobe PDF |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。