| Summary: | 碩士 === 臺中健康暨管理學院 === 健康管理研究所 === 92 === Traditionally, health care providers use paper charts to store all medical documents. As the information technique developed, it becomes a trend to adopt EMR (Electronic Medical Record) to save the medical records. EMR has many advantages, such as: avoiding duplication, reducing cost, easily to recognize the content, and can be interchanged immediately, …etc. However, there are some problems of applying EMR, for example, security issue, high investment cost, the barrier to people using paper chart. According to “2002 National EMR status Investigation” in Taiwan, there is 77% computerization in Western clinics, 76% in Chinese clinics, 71% in Dental clinics, and 75% computerization in all clinics of Taiwan. The extent of computerization and adopting EMR in different clinics is quite different. But the reasons of the differences are not clear. This study explores predictors of computerization and EMR acquisition in three different clinics.
This study used dataset of “2002 National EMR status Investigation” in Taiwan to conduct logistic regression analysis using SPSS.
Research results show that comparing to staff interaction and operation condition of three kinds of clinics. More standard operation procedures exist in Western and Chinese clinics than in Dental clinics. The staff in Chinese and Dental clinics has more autonomy than Western clinics staff. For the attitude toward government policy, Chinese and Dental clinics support government’s implementing EMR policy more than Western clinics do. Insufficient legislation and privacy problem affect Western and Dental clinics more than Chinese clinics.
This study finds certain characteristics are more likely to be associated with higher computerization: working hours a week of the clinic, the full-time information professional (Western and Dental clinics), information budget a year, staff interaction and operation condition and staff’s autonomy (Dental clinics only), government implement factor.
As the factors relate to EMR acquisition: information budget a year (Western and Dental clinics), government implement factor, government assistance and insufficient legislation factor (Western clinics only), intranet (Western and Chinese clinics), ambulatory system, number of personal computers (Western and Dental clinics) were more likely to associate with EMR acquisition.
To sum up, Western, Chinese and Dental clinics have different attitude toward government policy and encounter different difficulties. Policy makers need to consider these different difficulties and provide necessary interventions for different clinics. Since new Medical Law was enacted at April 2004 in Taiwan, the medical record could be stored in electronic format. Each clinic should prepare itself to meet the implement of EMR.
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