以醫師觀點探討看診輔助系統建置之研究;The Development of a Clinical Decision Support System from the Perspective of Physicians

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Title:	以醫師觀點探討看診輔助系統建置之研究;The Development of a Clinical Decision Support System from the Perspective of Physicians
Authors:	江啟彰;JIANG,CI-JHANG
Contributors:	資訊管理學系
Keywords:	候診時間;醫病關係;醫師行為;patient waiting time;patient doctor relationship;Clinical Decision Support System
Date:	2014-07-17
Issue Date:	2014-10-15 17:08:15 (UTC+8)
Publisher:	國立中央大學
Abstract:	台灣醫療環境長久存在候診時間過長及看診時間較短的現象，時常造成醫療糾紛、醫病關係惡化及病患忠誠度下降的現象。然而受限於有限的醫療資源(例如:醫師人數不足) ，想要改善上述現象有一定的挑戰。為此，本研究以運用候診時間的觀點著手，設計一套「看診輔助系統」，讓病患於候診時寫下想讓醫師了解的資訊，並回答醫師想要詢問病患的一般性問題(例:病患是否有藥物過敏)，接著將此資訊傳至醫師的電腦。當實際看診時，醫師可快速瀏覽這些資訊，並詢問較深入或不清楚的地方。此系統預期貢獻包括(1)轉移病患注意力，降低病患對長時間等待的感知、(2)幫助醫師快速且更深入的了解病情、作出正確判斷、(3)改善醫病關係，提升病患忠誠度，達到病患滿意、醫院獲利的雙贏局面。「看診輔助系統」的開發分成二個子計劃: (1)醫師編輯問卷及看診所使用的系統與、(2)病患使用的APP。本研究主要是開發醫師編輯問卷及看診系統的子計劃，同時探討醫師對於導入「看診輔助系統」對醫師工作效率及對醫病關係的影響。本研究以新北市及桃園市兩間區域醫院為合作對象，邀請實驗參與人員分別為7位專科醫師及7位醫護人員，透過訪談及問卷調查的方式進行。本研究結果顯示： (1). 透過QUIS問卷測得看診輔助系統介面的易用性偏中等，平均分數為128.91。 (2). 70%的受訪者認為「看診輔助系統」若能整合現行醫療系統(如：HIS)，能得到較高的效益。 (3). 54%的受訪者認為透過看診輔助系統可分攤醫師例行性問診的部分時間，提昇看診效率。 (4). 36%的受訪者認為「看診輔助系統」對醫病關係的正向影響(如:能降低與沒耐心的病患摩擦的機會)。 (5). 另外有36%的受訪者認為「看診輔助系統」對醫病關係的幫助不大，認為應從現行的醫療體制(如全民健保)的問題上改進。整體而言，看診輔助系統對醫師的工作效率及醫病關係的建立具有正面的影響，透過本研究的實驗過程可以清楚了解醫師對醫療系統需求，將有助於日後導入系統更為順利。 ;Patient waiting time in hospitals has increased gradually due to the rapid population growth in Taiwan. The longer waiting time patients have, the worse patient-doctor relationship may be. Due to limited medical resources (e.g. lack of physicians), it is difficult to shorten patient waiting time. Hence, this study was designed to effectively use patient waiting time to help physicians make proper diagnosis, by developing a Clinical Decision Support System (CDSS). The development of the CDSS was separated into two projects. One is an online information system in which physicians can edit questions for patients to answer. The other is an App for patients to fill in information that they would like to share with physicians (e.g. history of drug usage). In this study, we focus on the former one. Specifically, the aim of this study was to develop the CDSS, and to examine the effect of the CDSS on physicians’ work efficiency and patient-doctor relationships. Key results 1. Around 50% of the respondents were satisfied with the user interfaces in the CDSS. 2. 70% of the respondents suggest that it is important to integrate the CDSS into the existing information systems in hospitals (i.e., Hospital Information System). 3. 54% of the respondents indicate that the CDSS can improve their work efficiency. 4. 36% of the respondents believe that the CDSS has positive effects on doctor-patient relationships. 5. 36% of the respondents reply that the CDSS may not be helpful for doctor-patient relationships; they suggest that the current healthcare policy (i.e., National Health Insurance) was the main reason causing negative doctor-patient relationships.
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