| Abstract: | 1.探討國內醫院應用電子病歷於該院傳染病通報系統之效益評估；2.了解醫院應用電子病歷於傳染病通報之過程中，所面臨的問題，並提出改進建議方案。主要之工作項目及內容分為四項：1.傳染病通報欄位之格式與內容應加以定義與標準化：規劃可供參考之傳染病通報欄位與格式之定義與標準化；並設計新的醫院傳染病通報系統；2.進行獨立平行測試，了解以現行通報方式與以電子病歷通報在時效性與通報率之比較：將利用設計完成之傳染病通報欄位與格式，並使用新的醫院傳染病通報系統，在中山醫學大學附設醫院進行平行測試，並了解現行通報方式與以電子病歷通報在時效性與通報率之差異。3.以電子病歷應用於傳染病通報流程，每一位需通報之個案，院內所需人力、時間等評估指標之量化數據：搜集每一個需通報的個案及其通報過程的資訊，同時分析新的通報系統及舊的通報系統所需的時間、人員使用系統的詳細時間等量化數據，以比較新舊系統的作業成效；其步驟包括：(1) 模擬測試(2)訪談使用系統的人員(3)平行測試(4)搜集及比較新舊系統的作業成效；4.了解醫療院所在使用過程中(含資訊技術面及行政實務面)面臨之問題及提出建議方案：本計畫採用關鍵績效指標(Key Performance Indicators， KPI)進行效益評估。除了傳染病通報個案所需的人力、時間等量化指標之外，提供更多不同面向的評估資訊，以供日後導入於更多醫院時參考，本計畫參考King and Rodriguez (1978)所提之態度、認知價值、資訊使用程度與決策效能等四個衡量構面為基礎，提出整體績效評估架構。建立醫院應用電子病歷於傳染病通報系統將產生以下之效益，並提供我國防疫政策之參考：1.及時通報傳染性疾病；2.通報的時效可以量化；3.可提供傳染性疾病通報政策之事前決策評估及事後檢討；4.提供世界衛生組織的參考；5.法定傳染病資料可提高可信度和正確性；6.正確且及時的傳染病通報資料，可以得到國際的認可，我國的傳染病通報資料可以和他國進行比較分析，並和各國交流及分享我國的發展經驗。
The goals of this study are, 1) to do benefit evaluation for applying hospital’s electronic medical records to the communicable diseases reporting system, and 2) to identify the challenges and problems in the applying processes, and submit proposal of solutions. There are four major tasks in this study: 1) to define and standardize formats and contents of communicable diseases reporting system: the new-designed formats and contents will be used to develop a new reporting system, 2) to conduct parallel-tested comparing the timely efficiency and rate of notification between old and new reporting systems: the new reporting system will be parallel-tested in Chung Shan Medical University Hospital, to evaluate the performance of new system, 3) to apply hospital’s electronic medical records to the communicable diseases reporting system; to document each reported case, including the manpower used, time consuming, etc.; the following steps of this stage are: a) to do simulating test, b) to interview medical professionals who have to use reporting system, c) to conduct parallel-tested, and d) to collect data and to do evaluation; 4) to identify the challenges and problems in the applying processes, including technological and administrative problems, then to propose possible solutions: this study will adopt KPIs (Key Performance Indicators) to do benefit evaluation, and use model of King and Rodriguez to conduct a multiple-dimension evaluation. The benefits of applying hospital’s electronic medical records to the communicable diseases reporting system are shown below: 1) to provide timely reporting system, 2) to operationize the efficiency of communicable diseases reporting system, 3) to prepare information for evaluation and review before and after implementing a new communicable disease control program, 4) to provide reliable data of communicable disease for WHO, 5) to improve the quality and accuracy of reporting notifiable communicable diseases, and 6) to share experiences of communicable disease control programs with countries around the world. |
