| Abstract: | 重複用藥對於醫師、藥師甚至於民眾這三者的相關原因有很多，最基本的情況可以說是沒有建立起完整的醫病關係。因為病情描述、習慣用藥與療效反應經驗，以及病情的演變，都會影響醫師對病況的了解。追問與分析用藥問題，也會影響醫師的判斷與診斷。加上病人心理上求好心切，期待「特效藥」、期待盡快改善「不舒服」，信賴「名醫」及「?家」，要求更多或更特效的藥物，也都容易造成重複處方。在台灣，健保制度讓求醫就診方便，加上之前的診治沒有立即的改善病況，很容易造成重複處方的狀況，本研究擴及到醫師端與藥師端對於雲端藥歷系統的認知差異更全面性來進行探討與研究，讓雲端藥歷系統對於使用者影響的真正因素為何。
本研究修正DeLone and McLean(2003)資訊系統成功模型中分析比較不同二個臨床使用者醫師與藥師及整體使用者對之前與預期雲端藥歷之系統品質、資訊品質、服務品質、使用意願，以「使用意願」做為系統成功代理指標，分二組(醫師、藥師)個別為四個構面作為研究架構。
最重要一點為工作績效是對整個雲端藥歷使用的重大因素不論醫師與藥師均是，可見對於雲端藥歷系統的依賴程度逐年攀升，可以大大改善先前的工作績效減少過去用藥上的問題，使用雲端藥歷容易得知病人是否重複藥用等因素 。
本研究之成果顯示雲端藥歷做為一個資料庫的原意與現在雲端系統不同，被賦予愈來愈多任務及要求，系統會肥大且速度變慢，應依使用者需求 提供介面。另外醫師是依政策去看雲端系統資訊，可能會造成政策出發點與實際不一致，建議以醫師為中心設計雲端系統，讓醫師願意去使用。
There are many reasons for the repeated use of drugs for physicians， pharmacists, and even the public. The most basic situation can be described as the failure to establish a complete relationship between doctors and patients. Because the description of the disease, the experience of habitual medication and response, and the evolution of the disease, will affect the doctor's understanding of the condition. Questioning and analyzing medication problems can also affect the doctor's judgment and diagnosis. In addition， the patient is psychologically seeking good intentions， expecting "special effects medicine", expecting to improve "uncomfortableness" as soon as possible, trusting "famous doctors" and "my family", and asking for more or more special effects drugs will also easily lead to repeated prescriptions. In Taiwan, the health insurance system made it easy for doctors to seek medical treatment. In addition, the previous diagnosis and treatment did not immediately improve the condition, which could easily lead to repeated prescriptions. This study was extended to the physicians and pharmacists to have a more comprehensive understanding of the cloud drug calendar system. Sex conducts research and research to determine the real factors that influence the user's influence on the cloud drug calendar system.
This study revised the De Lone and McLean (2003) information system success model to analyze and compare the system quality, information quality， service quality, and willingness to use of two previous clinical practitioners， pharmacists, and users as a whole. The "willingness to use" is used as a proxy indicator for the system's success. The two groups (physicians and pharmacists) have four facets as the research framework.
The most important point is that work performance is a major factor in the use of the entire cloud medical record, regardless of the physician and pharmacists . It can be seen that the dependence on the cloud phlegm calendar system is increasing year by year. Can greatly improve the previous performance of the work to reduce the problems in the past medication, use the cloud medicine calendar to easily know whether the patient repeated the use of drugs and other factors. It is expected that the results of this study show that the original meaning of the cloud medicine calendar as a database is different from the current cloud system. With more and more tasks and requirements being given, the system will become hypertrophic and slow, and the interface should be provided according to user needs. In addition, doctors are looking at cloud system information according to policies, which may cause inconsistency between the policy starting point and the actual situation. It is recommended that doctors be the center of the cloud system design, so that doctors are willing to use. |
