論文名稱：影響醫生使用電子病歷的驅力與阻力之研究	頁數：47
校系(所)組別：淡江大學企業管理學系碩士在職專班
畢業時間及提要別：100學年度第2學期學位論文提要     
 
 
研究生：翁玉霞	   	指導教授：吳坤山 博士

論文提要內容：  


   有鑑於電子病歷(Electronic Medical Record, EMR)具有減少醫療疏失、提升醫療品質、提高醫師的看診效率等優點，世界先進國家皆積極發展中。醫師是使用電子病歷系統最主要且為最關鍵的人物，如同任何一項新科技產品剛發明或剛上市的時候，定有部分消費者願意採用新科技產品，部分消費者則會抗拒使用新科技產品，電子病歷系統的使用對醫生來說也是如此。
然而在紙本病歷數位化的前提下，除了須仰賴資訊技術環境的改善外，醫生在繁重的工作負荷下，尚需不斷學習新的相關技能，及配合電子化尚須接受適當的操作訓練，否則將無法勝任此工作的改變。醫生對這些額外工作上的要求，其接受程度也大不一致，特別是其對電子病歷推動的接受度與行為意向之問題，更是鮮少有研究對其加以探討。緣此，本研究將以國內各醫院包括醫學中心、區域醫院及地區醫院的執業醫師為研究對象，探討醫生使用電子病歷系統的不公平認知、感到威脅性、認知有用性、知覺行為控制、主觀規範與使用意向間之關聯。本研究總計發放122份問卷，因採現場人員發放問卷及同時回收，故回收樣本數為122份，有效樣本回收率為100%。透過敘述性統計、信度分析、效度分析、及結構方程模型(Structural Equation Modeling, SEM)中之偏最小平方估計法(Partial Leat Square, PLS)進行分析，其主要研究結果如下：
1.醫生對電子病歷的認知有用性顯著正向影響行為意向。
2.感到威脅性顯著負向影響醫生使用電子病歷的意願。
3.不公平認知顯著正向醫生對電子病歷的認知威脅性。
4.知覺行為控制顯著正向影響醫生使用電子病歷的意願。
5.主觀規範顯著正向醫生對電子病歷的認知有用性。
關鍵字：電子病歷、感到威脅性、不公平認知、認知有用性、知覺行為控制、主觀規範、使用意向

Title of Thesis： 
The Drivers and Resistance of Doctors Adopted Electronic Medical Record System	 Total pages:47
Key word:	Electronic Medical Records (EMR), Perceived Threat, Perceived Inequality, Perceived Usefulness, Perceived Behavior Control, Subject Norm, Behavior Intention
Name of Institute:	Executive Master’s Program of Business Administration (EMBA) in General Management
Graduate date:	June, 2012	Degree conferred : Master
Name of student:	Weng, Yu-Hisa	Advisor: Wu, Kun-Shan, Ph.D       
	翁玉霞	        吳坤山　博士
Abstract:
In the light of the electronic medical records (EMR) has the advantages of reducing medical negligence, enhancing the quality of healthcare, improving the efficiency of the physician’s inspection service, and so on, advanced countries in the world are actively developing. Physicians are the most important and most critical figures who use electronic medical records system. As with any new technology products have just invented or newly launched, there must be some consumers willing to adopt new technology products, some consumers will be reluctant to use them. The similar phenomenon is also happened to the use of electronic medical records system by physicians.
However under the premise of digitizing paper-based medical records, except for relying on the information technology environment to be improved, doctors with heavy workload still need to keep on learning new skills, and to receive proper operational training to keep up the steps of digitization, would otherwise not be qualified for this change. With regard to these extra requirements, the acceptance of  doctors are inconsistent, especially on promoting acceptance of electronic medical records and behavioral intention, but few studies have explored it.
Therefore, with the practicing doctors from domestic hospitals, including medical centers, regional hospitals and district hospitals, as study object, the present research paper investigates the relationships of the use of electronic medical records system by doctors among percived inequality, perceived threat, perceived usefulness, perceived behavioral control, subjective norm, and behavior intention. This study surveyed 122 questionnaires, due to the site personnel put out and took back questionnaires simultaneously, thus recovery of the sample is 122, and the effective sample rate of 100%. Through analyzing of descriptive statistics, reliability analysis, validity analysis, and Partial Least Square (PLS) of Structural Equation Modeling (SEM), the main findings are as follows:
1.Doctors’ perceived usefulness towards EMR is significantly positively associated with their behavior intention.
2.Doctors’ perceived threat towards EMR is significantly negatively associated with their usage intention.
3.Doctors’ perceived inequality towards EMR is significantly positively associated with their perceived threat.
4.The perceived behavioral control is significantly positively is associated with their usage intention of EMR.
5.Subject norm is significantly positively associated with doctors’ perceived usefulness towards EMR.

目  錄
目  錄	I
表 目 錄	III
圖 目 錄	IV
第一章 緒論	1
第一節 研究背景及動機	1
第二節 研究目的	2
第三節 研究流程	3
第二章 文獻探討	5
第一節 電子病歷發展及預期效益	5
第二節 知覺行為控制及行為意向	8
第三節 認知有用性	9
第四節 主觀規範	11
第五節 不公平認知及感到威脅性	12
第三章 研究方法與設計	14
第一節 研究架構	14
第二節 研究假設	15
第三節 研究變項操作型定義與衡量	17
第四節 研究對象與範圍	20
第五節 資料分析方法	21
第四章 實證分析結果	23
第一節 樣本結構分析	23
第二節 研究變項之因果關係	24
第五章 研究結論與建議	32
第一節 研究結論與發現	32
第二節 管理意涵	35
第三節 研究限制	35
第四節 後續研究方向及建議	36
參考文獻	38
中文部分：  38
英文部分：  38
附錄一：正式問卷	46

表 目 錄
表4-1  正式樣本特性	24
表4-2  研究構面之信效度表	27
表4-3  相關係數矩陣	28
表4-4  研究模型路徑分析結果表	30
表4-5  影響行為意圖之路徑	31
表5-1  研究假說資料彙整表	32

圖 目 錄
圖1-1 研究流程圖	4
圖2-1 電子病歷發展的五大階段	5
圖2-2 衛生署近年推動電子病歷四大方向	7
圖3-1 研究假設和架構圖	14
圖4-1 本研究模式之路徑分析	30

中文部分：
1.Rich Lee’s Blog 資訊科技與文化, 行為意向(Behavior Intention) 分析 http://richchihlee.wordpress.com/tag/behavior-intention/。
2.李婉怡、趙珮如(2004)。醫療產業員工對電子病歷之科技接受模式探討-以中南部地區為例。醫務管理期刊，5(2)，243-269。
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4.黃秀麗(2010)。扶輪社會員入住養生村行為意向之研究。淡江大學企業管理學系碩士在職專班碩士論文。

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