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, 使用iOS作業系統下Objective-C程式語言設計一套「臨床決策支援系統」, 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。 本研究旨在探討臨床決策支援系統有用性以及易用性，同時此系統對病患在候診時間上的感知以及與醫師間醫病關係及信任感的影響。本研究以新北市某地區醫院為合作對象，以隨機方式調查該醫院門診病患使用此系統的感受。重要結果分述如下：(1) 超過半數的門診病患(60%)對於臨床決策支援系統的有用性、易用性感到滿意; (2) 54%病患最長能忍受候診時間大約為60分鐘; (3)臨床決策支援系統能顯著影響病患感知候診時間; (4)臨床決策支援系統對於病患與醫師間醫病關係信任均有顯著正向影響。 本研究主要貢獻包括(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，達到病患滿意、醫院獲利的雙贏局面。整體而言，臨床決策支援系統對於病患感知候診時間具有正面影響，並且系統有用性以及易用性上也得到病患較高的滿意度，透過本研究可以清楚了解病患對臨床決策支援系統更具體的系統需求，將有助於未來看診方式以及系統導入。 ;Long waiting time in hospitals has been reported to cause discontent among patients. The longer waiting time patients have, the worse patient-doctor relationship may be. Due to limited medical resources, it is difficult to decrease outpatient-waiting time. Hence, this study develops a clinical decision support system (CDSS) to shorten patients’ perception of waiting. The proposal is that patients are asked to use the CDSS while they are waiting for diagnosis. The CDSS allows patients to enter their symptoms and any questions/information they want to forward to physicians. Finally, the Technology Acceptance Model (TAM) was used to examine the effect of the present proposal (i.e., CDSS) on both patients’ perceived waiting time and patient-doctor relationships. This study investigated patients′ acceptance of CDSS in a local hospital in Taiwan. The main results are as follow: (1) About 60% of the patients show a good response to the CDSS on both the Perceived usefulness (PU) and Ease of use (EOU). (2) About 54% of the patients only willing to wait around 1 hour in the waiting room. (3) CDSS did affect the patient’s perceived waiting time. (4) CDSS demonstrated positive effect on both the patient-doctor relationship and trust.
