影響基層診所醫師使用電子病歷滿意度之研究

Background: Emerging health information technology has been generally adopted by primary care physicians to enhance quality of care and improve service of process in Taiwan. Particularly, Electronic Health Records (EHRs) has become one of the major issues for healthcare provider due to change by government policy and financial subsidy. Objective: To investigate variables which influence primary care physicians' satisfaction on using EHRs. Methods: Our subjects are primary care physicians who have applied the subsidy to implement EHRs sponsored by the Department of Health. We conducted the survey by a valid and reliable questionnaire. A total 1103 questionnaires were distributed to physicians, 556 useable responses were received resulting in a response rate of 53.77%. Results: From the multiple regression, we found that monthly service volume of primary care physicians: 1000-1999, 2000-2999 and above 3000 (β=0.193, p＜0.001；β=0.149, p＜0.001；β=0.118, p=0.002), cost effectiveness (β=0.164, p＜0.001), perceived ease of use (β=0.273, p＜0.001), subjective norms (β=0.228, p＜0.001), security (β=0.166, p=0.019) and willingness to use (β=0.161, p=0.01) had significantly positive effects on EHRs satisfaction. However, privacy had negative effect on EHRs satisfaction (β=−0.242, p=0.001). This model can explain 49.9% variance (Adjusted R2 =0.499). Conclusion: Perceived ease to use, subjective norms, security and privacy, intention and cost-effectiveness of using EHRs had significant effects on primary care physicians' satisfaction. Therefore, we believe that primary care physicians' satisfaction will be raised if EHRs can enhance clinical and daily works effectively, provide easy and user-friendly interface, assured security and privacy, and accompanied by government's promoted policy.