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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 郭年真 | zh_TW |
dc.contributor.advisor | Raymond N. Kuo | en |
dc.contributor.author | 楊思暉 | zh_TW |
dc.contributor.author | Szu-Huei Yang | en |
dc.date.accessioned | 2024-02-26T16:12:11Z | - |
dc.date.available | 2024-07-20 | - |
dc.date.copyright | 2024-02-26 | - |
dc.date.issued | 2023 | - |
dc.date.submitted | 2023-12-29 | - |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/91869 | - |
dc.description.abstract | 研究背景:電子病歷為醫療資訊之基石,多年來電子病歷共享對提升病人安全及提高病患滿意度有所貢獻,而病歷分享不僅為文字,醫療影像更是重要的一環。健保署於民國107年啟動醫療影像上傳與調閱政策至今逾5年,印證高價影像檢查如電腦斷層(CT)及磁振造影(MRI)之重複檢查明顯下降,因而減少健保支出。
研究目的:期透過本研究了解醫師對於「健保醫療資訊雲端查詢系統影像調閱瀏覽器」之使用現況分析與潛在需求。 研究方法:運用質性研究,以半結構式個人深度訪談(in-depth individual interview)方式,透過內容分析法(Content Analysis)執行資料分析與歸納,作為本研究結論。 研究結果:本研究共收案19位不同科別及醫療機構層級醫師,多數醫師因為「診療需求與診斷確認」而進行調閱,調閱頻率最多落於100診療人次約20-30次;CT及MRI仍為被調閱最多的影像,種類會因科別不同。針對影像與報告之重要性與參考價值上,多數內科系及急診一致認為報告重要性高,多數外科系醫師認為影像價值高,唯耳鼻喉科及神經內科醫師較不一致,因個人看診習慣有異。大部分醫師給予此平台70-80分之評價,但仍重視以下議題包括「影像或報告不完整」、「影像品質不一」、「系統功能與UI問題」、「連線/網路品質問題」…等。醫師認為此平台對於醫療體系之貢獻,包括「降低醫療資源浪費」、「提升診斷即時性」,以及「提高診療精準度」。而對未來延伸需求最重視「AI輔助相關需求」,亦為現今熱門議題仍多被醫師提及。 結論:「健保醫療資訊雲端查詢系統影像調閱瀏覽器」對於台灣整體醫療貢獻不容小覷,尤以減少醫療資源浪費、提升診斷即時性與精準度上,普遍受醫師們肯定,也因此對於醫病關係有所改善且讓醫療品質與病人安全獲得提升。 | zh_TW |
dc.description.abstract | Background: Electronic medical records serve as the cornerstone of medical information. Over the years, the sharing of electronic medical records has made significant contributions to enhancing patient safety and increasing patient satisfaction. Medical record sharing is not just limited to texts as medical images are equally important. It has been more than 5 years since the National Health Insurance Administration initiated the policy for uploading and accessing medical images in 2018. The policy has seen a significant decrease in the number of repeated high-cost imaging examinations such as computed tomography (CT) and magnetic resonance imaging (MRI), thereby reducing national health insurance expenditures.
Objective: The purpose of this study is to investigate the current usage and potential needs of physicians regarding the "NHI MediCloud Information System Image Access Browser". Methods: Qualitative research approach and the method of semi-structured in-depth individual interviews are employed to conduct data analysis and induction via content analysis to reach a conclusion for this study. Results: This study included a total of 19 physicians from various medical specialties and healthcare institution levels. The majority of the physicians accessed the system primarily for "clinical needs and diagnostic confirmation," with most physicians accessing medical images 20-30 times per 100 patient cases. CT and MRI images remained the most frequently accessed images, with different medical specialties opting for different types of images. Regarding the importance and reference value of images and reports, physicians in internal medicine and emergency medicine unanimously considered reports to be highly important. However, surgeons tended to place a higher value on images. There were some inconsistencies among otolaryngologists and neurologists, which may be attributed to individual clinical habits. Most physicians rated the platform a 7 or 8 out of 10, but raised concerns about "incomplete images or reports," "inconsistent image quality," "system functionality and UI issues," and "connection/network quality problems." Physicians acknowledged the platform's contributions to the healthcare system, including "reducing medical resource wastage," "enhancing diagnostic immediacy," and "improving diagnostic accuracy." When it comes to future expansion, physicians emphasized a strong interest in "AI-assisted functionalities," reflecting the current trend and ongoing discussions within the medical community. Conclusions: The "NHI MediCloud Information System Image Access Browser" has made significant contributions to the overall healthcare system in Taiwan. It is generally recognized by physicians for its impact on reducing medical resource wastage and enhancing diagnostic immediacy and accuracy, which has led to improvements in doctor-patient relationships as well as an overall enhancement of healthcare quality and patient safety. | en |
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dc.description.tableofcontents | 口試委員會審定書 I
謝 誌 II 摘 要 III ABSTRACT IV 目次 VI 圖次 VIII 表次 IX 第壹章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 3 第貳章 文獻回顧 4 第一節 電子病歷發展歷程 4 第二節 醫療影像之源起 6 第三節 醫療影像分享源起 8 第四節 國際醫療影像分享之發展 10 第五節 台灣醫療影像分享之發展 12 第六節 文獻回顧小結 14 第參章 研究設計與方法 19 第一節 研究設計與架構 19 第二節 研究對象與招募方法 20 第三節 資料蒐集與處理流程 21 第四節 資料編碼與分析 31 第肆章 研究結果 32 第一節 受訪者基本資料與特性分析 32 第二節 使用「健保醫療資訊雲端查詢系統影像調閱瀏覽器」之目的、頻率及內容 35 第三節 對「健保醫療資訊雲端查詢系統影像調閱瀏覽器」之期望、落差及因應方式 46 第四節 「健保醫療資訊雲端查詢系統影像調閱瀏覽器」對醫療品質之期許及延伸需求 51 第五節 研究結果小結 59 第伍章 討論 61 第一節 醫師對於「健保醫療資訊雲端查詢系統影像調閱瀏覽器」之關鍵需求 61 第二節 醫師認為「健保醫療資訊雲端查詢系統影像調閱瀏覽器」對健康照護體系之貢獻 68 第三節 醫師對於影像之延伸需求:影像AI的未來應用 70 第四節 研究限制 71 第陸章 結論與建議 72 第一節 結論 72 第二節 建議 74 第柒章 參考文獻 76 第捌章 附 錄 81 附錄一、國立臺灣大學行為與社會科學研究倫理委員會審查核可證明 81 附錄二、知情同意書 82 | - |
dc.language.iso | zh_TW | - |
dc.title | 醫師於健保醫療資訊雲端查詢系統影像調閱現況分析與需求探討 | zh_TW |
dc.title | An Analysis on the Current State of Physicians' Access to Images in NHI MediCloud System & Investigation into Related Requirements | en |
dc.type | Thesis | - |
dc.date.schoolyear | 112-1 | - |
dc.description.degree | 碩士 | - |
dc.contributor.coadvisor | 張耀懋 | zh_TW |
dc.contributor.coadvisor | Yao-Mao Chang | en |
dc.contributor.oralexamcommittee | 鄭守夏;莊旺川 | zh_TW |
dc.contributor.oralexamcommittee | Shou-Hsia Cheng;Wang-Chuan Juang | en |
dc.subject.keyword | 影像調閱,影像共享,健保醫療資訊雲端查詢系統,醫師, | zh_TW |
dc.subject.keyword | medical image access,medical image sharing,NHI MediCloud System,Physicians, | en |
dc.relation.page | 84 | - |
dc.identifier.doi | 10.6342/NTU202304569 | - |
dc.rights.note | 同意授權(限校園內公開) | - |
dc.date.accepted | 2024-01-02 | - |
dc.contributor.author-college | 公共衛生學院 | - |
dc.contributor.author-dept | 健康政策與管理研究所 | - |
顯示於系所單位: | 健康政策與管理研究所 |
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